New SS Referral

Student View

ALLEN, Andrew Parker

Grade 9 : Rydell High School

SSID : 101758

Date :

Student Name :

School :

Grade :

HR Teacher :

Student Address :

Phone Number :

SSN number :

Date of Birth :

Age :

Gender :

Race :

Medicaid # :

Parents/Guardian Name :

Phone :

Presenting Issue :

Concerns :

Dates of Actions Before Referral to Social Worker :

Actions Before Referral :

Phone Call

Mailed Letter

Letter sent home with Student

Conference with Parent/Guardian

Unable to contact Parent/Guardian

SS Case #78550

06/24/2020 08:30

Presenting Issue : Pregnancy / Suspected Pregnancy - Child Abuse / Suspected Child
STUDENT	ALLEN, Andrew Parker Grade 9, Rydell High
HR TEACHER	Lindsay Acosta, Teacher
STUDENT ADDRESS	123, Sloan Lane, Athens, AL - 35611.
PHONE NUMBER	123-456-7890
SSN	123456789
DATE OF BIRTH	12/22/2005
AGE	15
GENDER	F
RACE	W
MEDICARE NUMBER
PARENT/GUARDIAN NAME	Will Parker, Sarah Parker
PHONE	123-456-7890
CONCERNS	Other students reported that the student said she was pregnant. Other observations were made to suspect possible abuse.
BY	Lindsay Acosta

Response

06/24/2020 09:06

BY	Lindsay Acosta , Teacher
ACTIONS	Phone Call : 09/20/2019 Mailed Letter : 09/22/2020

Alert Name	Condition	Alert Action	Available for School Admins	Active/Inactive	Action
ALLEN, Andrew Parker	Attendance : Absent	Email/Popup/Email-SMS
3 ODRs or more	Number of ODRs : 3+	Popup/Dashboard/Alert/Email/Email-SMS