Get Psychiatric Referral For Home Instruction - Los Angeles Unified Bb

This guide provides a comprehensive overview of how to fill out the Psychiatric Referral For Home Instruction form for the Los Angeles Unified School District. It aims to assist users in completing the form accurately and efficiently.

Follow the steps to expertly complete the referral form.

1. Click the ‘Get Form’ button to access the document and open it in the designated editor.
2. Begin by filling in the student information section, including last name, first name, date of birth, grade, and primary language. Ensure all details are accurate to avoid delays.
3. Provide the address, including city and zip code. Enter the home, cell, and work phone numbers where reachable.
4. Complete the parent or guardian information section, including their name and preferred language for communication.
5. Indicate the cumulative carrying school and provide its contact number. Also, specify the last date of attendance.
6. Confirm whether the student has a current Individualized Education Program (IEP) or a 504 Plan by selecting 'Yes' or 'No' and include eligibility details.
7. Check all applicable modified programs or other educational options that have been tried, providing additional comments if necessary.
8. Read through the implementation of service section, and indicate understanding of conditions by signing with the parent or guardian's name and the date.
9. On the second page, a licensed California psychiatrist must complete the necessary fields, including diagnosis, therapeutic plan, medication, and safety assessment.
10. Once the form is fully completed, proceed to save changes, download, print, or share the document as required.

Complete your psychiatric referral form online today for efficient processing and support.