NCS Critical Support Team Remote Referral
If a crisis has occurred and you need support, please use this form. Someone will contact you ASAP
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Email *
Name of Individual Being Referred *
Name of Person Completing Form
(If different than the person being referred)
Concerns (Why do you feel this person needs to be contacted? This helps with determining how to support the individual.) *
Contact Method- provide phone, email, etc. of the person you are are referring *
Best Time to Contact
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