Counseling Services Referral Form for Students
The Counseling Services Referral Form assists faculty and staff in identifying students in need of help. This document allows timely assistance to those who may be facing challenges. Fill out the form to facilitate support for students' academic and personal well-being.
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How do I fill this out?
To fill out the Counseling Services Referral Form, begin by providing the date and the student's name. Next, you will need to include the student's ID number and classification. Finally, detail the concerning behavior and type of referral to ensure proper assistance.
How to fill out the Counseling Services Referral Form for Students?
1
Fill in the date, student name, and ID number.
2
Indicate the classification and major of the student.
3
Choose the type of referral needed.
4
Describe the concerning behavior of the student.
5
Provide your contact information and submit the form.
Who needs the Counseling Services Referral Form for Students?
1
Faculty and staff who recognize a student struggling academically.
2
Counselors looking to document and track student referrals.
3
Administrators aiming to provide resources to at-risk students.
4
Parents concerned about their child's emotional well-being.
5
Students themselves who may wish to ask for help but need a formal referral.
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What are the instructions for submitting this form?
To submit the Counseling Services Referral Form, fill it out completely and save it on your device. Attach the completed form in an email addressed to BernardV@hssu.edu. Ensure you provide your contact information, so follow-ups can be facilitated if necessary.
What are the important dates for this form in 2024 and 2025?
Important dates for submitting the Counseling Services Referral Form include the start of each semester and any special mental health awareness weeks. Be sure to keep an eye on the academic calendar for specific deadlines.
What is the purpose of this form?
The purpose of the Counseling Services Referral Form is to provide a structured method for faculty and staff to identify students in distress. By facilitating early intervention, we can help students access resources that promote their academic success and personal well-being. This proactive measure ensures that students receive the support they need in a timely manner.
Tell me about this form and its components and fields line-by-line.
- 1. Date: The date the form is filled out.
- 2. Student Name: The full name of the student being referred.
- 3. ID#: The student identification number.
- 4. Classification: The academic standing of the student (e.g., freshman, sophomore).
- 5. Major: The student's field of study.
- 6. Type of Referral: The reason for the referral (e.g., academic, personal).
- 7. Explanation: Details if the referral type is 'Other'.
- 8. Concerning Behavior: Description of the concerns regarding the student.
- 9. Referred By: The name of the faculty or staff member making the referral.
- 10. Title: The title of the person making the referral.
- 11. Department: The department of the individual making the referral.
- 12. Campus Phone: Contact number for follow-up.
- 13. Student Awareness: Indicates whether the student is aware of the referral.
What happens if I fail to submit this form?
If the Counseling Services Referral Form is not submitted, the student may miss out on valuable support services. This could lead to worsening academic or personal challenges for the student. Timely referrals are crucial for early intervention.
- Lack of Support: Students may not receive the help they need.
- Increased Distress: Without intervention, students may experience heightened distress.
- Missed Opportunities: Students may miss chances for academic success.
- Communication Gaps: Information may not reach counseling services in time.
- Longer Recovery Times: Delays can result in prolonged recovery or assistance periods.
How do I know when to use this form?
- 1. Academic Struggles: For students showing difficulty in their studies.
- 2. Emotional Distress: If a student exhibits signs of emotional or mental health issues.
- 3. Social Challenges: For students facing social anxiety or peer-related issues.
- 4. Behavioral Concerns: If a student's behavior changes significantly.
- 5. Crisis Situations: In urgent cases where immediate support may be required.
Frequently Asked Questions
How can I edit the Counseling Services Referral Form?
You can easily edit the form using the PrintFriendly editor. Click on the fields you wish to change and input the correct information. Save your edits when finished.
How do I submit the filled-out form?
After completing the form, save it to your device and attach it in an email to the designated contacts. Follow up to ensure your referral is received.
Is there a way to sign the form electronically?
Yes, PrintFriendly offers an electronic signature tool that allows you to sign the PDF easily. This feature facilitates authorizing your submission.
Can I share the form with others?
Absolutely, you can share the edited PDF through various platforms directly from PrintFriendly. This makes collaboration easy.
What types of referrals can this form handle?
The form accommodates academic, personal, social, and mental/emotional health issues. Be sure to indicate the type needed.
Do I have to be a staff member to submit this form?
While the form is primarily for faculty and staff, anyone concerned about a student's well-being can facilitate a referral.
What if I need to edit the PDF after sharing it?
You can always go back to PrintFriendly, open the PDF again, make necessary changes, and then re-download it.
Is there a limit to the changes I can make to the form?
No, you can make as many edits as needed before finalizing the document and downloading it.
How can I ensure my referral is confidential?
All submissions are handled with confidentiality as outlined in the form instructions. Ensure you communicate this to the student.
What steps should I follow if my referral is not responded to?
If you do not receive a response, consider reaching out to the counseling services directly to follow up on your referral.
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