Resources for School-Based Counselors

Mental Health Referrals

Parent Consent form English (use for mental health referral to Tier III, signed forms are uploaded into Optiflow and Focus in Counselor Notes)

CHS Consent for Assessment or Treatment (send home with Parent Consent for students being referred to CHS only)

Parent Consent form Spanish (use for mental health referral to Tier III, signed forms are uploaded into Optiflow and Focus in Counselor Notes)

Optiflow Form (use for sending the mental health referral to the clinicians)

Suicide and Self-Injury Assessments (Upload to Self-Harm Risk tab)

Safe-T Protocol with C-SSRS (use to Screen for Suicide)

Suicide Risk Assessment (use to identify underlying issues, must ask the last two questions)

Parent Acknowledgment Form (use when the parent comes to the school and you explain the need for further assessment)

Safety Plans

Safety Plan (Use upon return to school from a Baker Act)

Stress Reduction and Re-entry Plan (Use upon return to school from a Baker Act)

Success and Safety Plan Review (Use to review Stress Reduction Plan, 1 month out)

Threat Assessment Reporting

Ed Click School Safety Manager (use to report a threat or work a threat as a member of the threat assessment team)

Mental Health Staff Use Only

Informed Consent Form

Miscellaneous Resources

Mobile Response Team Information

Mental Health Services