Refer a Student

Educators, school staff, and parents can refer a K-12 student to our clinical team.

If a student is in immediate danger: call 911 or 988 (Suicide & Crisis Lifeline). For urgent — but not emergency — referrals, call us at (404) 832-0102.

Referral Form

All fields marked with * are required. We follow FERPA and HIPAA standards.

About you (the referrer)
School information
Student information
Parent / Guardian (optional)
Referral details
Insurance (optional)
Required acknowledgments