Social Service Referral
Grade 9 : Rydell High School
SSID : 101758
Race : W
DOB : 03/17/2006
Age : 14
HR Teacher : Lindsay Acosta
Referral / Case # 45
Submitted : 06/24/2020 08:30
| PRESENTING ISSUE: DEATH IN FAMILY – IN CLASS BEHAVIOR – OUTSIDE CLASS BEHAVIOR | |
|---|---|
| STUDENT | ALLEN, Andrew Parker
Grade 9, Rydell High |
| DESCRIPTION OF CONCERNS | Andrew has been action up in class and also at basketball games. I spoke with his mother and she stated that his dad had passed away in the past few weeks and he is having a hard time with it. |
| REFERRED BY | Anna Smith - Anna.Smith@bloombehavior.com |
| PRE-REFERRAL ACTION TAKEN | |
|---|---|
| ACTION | ALLEN, Andrew Parker
Grade 9, Rydell High |
| ACTION BY | Anna Smith - Anna.Smith@bloombehavior.com |
| SCHOOL ASSIGNED SOCIAL WORKER | Jack Brown - Jack.Brown@bloombehavior.com |