Lincoln Mental Health Referral Form
This is a form for students, staff, and parents to refer a student for a mental health and well-being check-in with the guidance staff at Lincoln High School.
Please fill out this form if you are concerned about yourself or a student at school. If someone is at imminent risk of harming themselves or others, or you perceive the situation to be an emergency, do not use this form, call 911.
*your information will be kept confidential with the guidance staff*
Email *
Referring: *
Student of Concern's First Name: *
Student of Concern's Last Name *
Referral made by: *
Concern: *
Priority *
Submit
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