FAST/Wellness Referral

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Black Oak Mine USD is focused on positive outcomes for all students and families in our community. The Family and School Together (FAST) Coordinator and team members are able to assist any student, teacher, and/or family in connecting to resources and services needed for supporting better achievement. Referrals can from staff, parents, teachers, or even students themselves. Please complete the form regarding how we can help.

Email *

Student Name *

Grade *

Area of Concern *

1 point

Transition to adulthood

Discipline/Defiance

CalFresh supports

Educational Supports

Support connecting to school community

Request specific household items

Career Guidance

Substance Abuse

Household Support

Life Skills

Temporarily Displaced

Visit Community Resource Closet

Attendance/Truancy

Social Skills

Family Conflict

Bullying/Violence

Medical, Dental, or Vision Supprts

Connecting to the HUBS

Self-Esteem/Victimization

Other:

Required

Additional information you would like to share: *

Best time and day for you to visit the Community Resource Center and Wellness Center for support:

What is the best way to connect with you? Please enter your email or phone number for FAST/WELLNESS to reach out to you. *

Thank you for your time and supporting the students in BOMUSD

Email bisham@bomusd.org or Text/Call Bridget Isham at 530-334-3305 with questions or additional concerns.

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