School Referral Form Please enable JavaScript in your browser to complete this form.YOUTH'S NAME *FirstLastPLEASE CHECK ANY OF THE FOLLOWING ISSUES THAT APPLY:Peer ConflictsMental HealthBCOP (Beyond Control of Parent)AttendanceFamilyRunning AwayAcademic PerformanceSuicidalGang InvolvementSuspensionsHomicidalOtherExplosion(s)Violence/AggressionBehavioral ReferralsSubstance UseSuicide Risk Assessment CompletedThreat Assessment CompletedPARENT/GUARDIAN NAMEFirstLastPHONE NUMBER FOR YOUTH OR PARENT/GUARDIAN *EMAILREFERRING PERSONS NAME *PHONE NUMBEREMAILPARENTS/GAURDIANS CAN ALSO CALL US AT 208-544-4357 TO SCHEDULE AN APPOINTMENTSubmit
