Healthy Start » Referral Forms

Referral Forms

I would like to help clarify a couple of points related to the Referral forms. The "referral form" can be used for all students that are in need of visiting the clinic. This form is for students that are not in a crisis situation and would like to be seen as soon as possible. Students are welcome to be sent with this form to the clinic but it does not guarantee an immediate appointment. They may be sent back to class and given a return appointment. Unlike the "Immediate referral form" this form can be used for students that are in a crisis situation. Crisis situations would include suicidal ideation, immediate family or personal crisis, and any other related issues that need immediate attention.

I hope this is helpful but if there are any further questions please email me with any other concerns. I will be making copies available to everyone by the end of the week.
Thank you everyone.

Erika Corral, MSW
Healthy Start Coordinator
Abraham Lincoln High School
3501 N. Broadway
Los Angeles, CA 90031
(323) 227-1794 office
(323) 223-1291 fax