Referral Form

Student Support Referral

Please use this form to submit a referral for student support. Your contact information will help us follow up if we need additional details.
This form is to be used only by families registered with the St. Clair Catholic School Board to request support from a school board mental health professional.

All information provided will be kept confidential and shared directly with Lori Brush, Manager of Mental Health Services, and the school social worker for necessary follow-up.

After you answer whether this referral is for yourself, additional questions will appear. Fields marked with *required are required.