Community Care Ticket Form

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Please fill out the relevant information about your request and the children who will be served as a part of the request. We use the information you provide to support our services, funding requirements, and quality improvement efforts.

Once your request is submitted, one of our staff members will be in touch within a 5 business days. Our team's response time will vary based on the amount of requests we are handling.

If you encounter any issues, please contact Sarah Canales (sarah.canales@slane.k12.or.us).

Email *

Record my email address with my response

What level of priority is this request? *

Does your request involve more than one child?

More than one child includes a family with multiple children and school events, for a couple of examples. One child includes a single child or a family where one child receives services.

Yes, more than one child

No, only one child

Other:

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