New Social Support Referral

- Simmons Parker
  
  Rydell High School
  
  9
- Simcox Shanley
  
  Rydell High School
  
  9
- Simmons Brown
  
  Rydell High School
  
  9
- Simmons Bolick
  
  Rydell High School
  
  9
- Simmons McLean
  
  Rydell High School
  
  9
- Simms Bolick
  
  Rydell High School
  
  9
Welcome ! Principal
Andrew

Welcome ! Principal

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Presenting Issue :

Note : All staff members are required to report abuse / suspected abuse directly to DHR. If other presenting issues present an additional need for the student (i.e. hygiene, food, etc.) then complete this referral after reporting the abuse / suspected abuse to DHR directly.

List Concerns :

List all Actions taken before referral to Social Worker with dates :

Actions Before Referral :

Phone Call

Mailed Letter

Letter sent home with Student

Conference with Parent/Guardian

Unable to contact Parent/Guardian

Submit Referral

General Misconduct: Uncooperative Behavior
STUDENT	ALLEN, Andrew Parker Grade 9, Rydell High
BY	Lindsay Acosta

Fighting Harassment : Horseplay or Shoving another student
STUDENT	ALLEN, Andrew Parker Grade 9, Rydell High
DESCRIPTION	Andrew Shoving another student
BY	Lindsay Acosta

BLOOM #	Date	Time	School	Type	Status	ODR	Staff Name	Student Name	Grade
60126	8/10/2017	2:00PM	Rosewood Middle	Discipline	Resolved		Lindsay Acosta ml-5 mr-5	Brown, Eva	6
60128	8/10/2017	2:00PM	Rosewood Middle	Discipline	Resolved		Lindsay Acosta	Allan, Andrew Parker	6

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