TLC Support Request
Use this form to request support for mental health, crisis support, personal and/or family resources, or anything else needed.  You can refer yourself, or someone else/another family in need.  You can choose to remain anonymous as well.  If you need urgent assistance on the weekend or non school day, please call Mr. Serbus at 612-361-5530 or PK at 952-496-5990.
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Your Last Name
Your First Name
Last Name of the Person of Concern *
First Name of the Person of Concern *
What is the Concern? *
How can the TLC help? What is needed from the TLC to support the concern? *
What is the best way to contact you?  (e.g. phone, email, text) Please include the contact information.   *
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