Get Student Assistance Referral Form - Care Of Southeastern Michigan

Filling out the Student Assistance Referral Form is an essential step in seeking support for students facing challenges. This guide provides a detailed walkthrough of the form to ensure it is completed accurately and efficiently online.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the referral date in the designated field to indicate when you are submitting the referral. This helps in tracking and managing referrals effectively.
3. Fill in the student’s name and date of birth (DOB) to associate the referral with the correct individual.
4. Select the school district the student is enrolled in from the appropriate dropdown or text field.
5. Provide the names of the parents or legal guardians of the student in the specified fields, ensuring accurate contact information is entered.
6. Indicate the telephone number where parents or guardians can be reached for follow-up communication.
7. Check the appropriate box to screen for substance abuse and/or mental health issues as applicable to the student’s situation.
8. If the student is currently working with a school social worker, counselor, or psychologist, check ‘Yes’ and provide their name, title, and phone number.
9. In the areas of concern section, select all relevant issues affecting the student, providing a comprehensive understanding of their current challenges.
10. Add any comments that may provide additional context or information helpful for the CARE clinician in assessing the student's situation.
11. In the follow-up information requested section, check at least one option to specify what feedback you would like after the assessment.
12. Complete the referring/authorizing personnel section with your name, title, school, and direct school phone number, including the extension if applicable.
13. Ensure the authorizing personnel's signature is provided as it is required for the fee per student school partnership.
14. Finally, review all the information entered for accuracy, then save the changes. Users can choose to download, print, or share the completed form as needed.

Complete the Student Assistance Referral Form online today to support students in need of assistance.