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Student Assistance Program (SAP) Referral Form
Your school SAP team is a
team
of specially trained school and community
agency staff who are available to help students
access school and community services. If a student
is having trouble in or out of school, we can
help. For more information about the Student Assistance Program at Trinity High School, please see the
THS SAP Brochure
.
If you have concerns regarding the health, safety, and/or well-being of a student at Trinity High School, p
lease fill out this
confidential
referral form
.
The referral information will be provided to the Student Assistance Team for follow up and action.
*** If you are concerned about the imminent
safety of a student, please make this report through
Safe2Say
for a 24/7 response.***
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* Indicates required question
Email
*
Your email
Option 1
Clear selection
Student Name (First & Last):
*
Your answer
Student Grade
*
9th
10th
11th
12th
Type of Concern (You may choose more than one)
*
Academic
Behavioral
Drug/Alcohol
Family
Health/Physical/Medical
Legal
Mental Health
Social
Required
Reason for Concern
*
Your answer
Name of Referral Source/Person Making Referral (First & Last)
Your answer
Best Contact Information for Referral Source
Your answer
Referral Source's Relationship to Student of Concern
Your answer
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