Please complete this referral as thoroughly as possible to ensure the Family Support Liaison has enough information to move forward with providing services.  Items with a red * are required information. Each school district in Linn, Benton and Lincoln counties has an intergovernmental agreement with the LBL ESD to share information about the referred student/family with the assigned Family Support Liaison to enable them to initiate contact with the referred student/family.

The assigned Family Support Liaison may contact you to clarify information or to get further detail as needed.  You will receive a follow-up contact (email or phone) once the Family Support Liaison has attempted to contact the student/family and/or initiated services.  Students/Families have the right to decline services, but Family Support Liaisons will work diligently to connect with the referred student/family and follow-up on this referral.