Whitehall High School Student Assistance Program Referral
SAP Referrals are only checked during the school day. If you are making this referral during after-school hours and your concerns are urgent in nature, please contact the Lehigh County Mental Health Crisis Hotline at (610) 782-3127 to receive immediate assistance. If there is a life-threatening emergency, call “911” or visit your nearest emergency room.


Please check observable behaviors and any comments for the student referred to the Student Assistance Program.

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What is the student's first name? *
What is the student's last name? *
Check reasons for concern *
Required
Please elaborate on the reason(s) for the referral and include any other pertinent information that would be helpful to the team: Observable information only *
Prior to this SAP referral, please check any actions taken to help this student *
Required
Is this referral a result of disciplinary action? *
Is this referral a result of a Student Attendance Improvement Plan? *
Has the parent/guardian received SAP paperwork as a result of disciplinary action or truancy? *
I would like to speak with a SAP team member regarding this student: *
Name and Contact Information
This will enable the team to contact you if they need further information.
This student may be a good candidate for
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