Group Referral
We care for the well being of all of our students. Please complete this form to submit a student referral. Group will be seen as soon as possible and in order of seriousness/emergency.
Communication with counselor is confidential. Thank you in advance for your cooperation.
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Email *
Name of person making referral *
Relationship to students *
Students names *
Students grades *
Required
Students' teacher(s)
Reason for referral *
Best times to meet with students
Please write your contact information for counselor to reach out to you
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Statement of Confidentiality
Thank you for caring and taking the time to complete the referral form. I will reach out as soon as possible. If you would like to set up an appointment or talk to the counselor, please call (956) 546-1805 or email at cmagallanes@cdobcs.org. Communication with counselor is confidential. If this is an emergency, please call 911.
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