2026-27 Behavior/Mental Health Services Referral Form

Thank you for using the Behavior/Mental Health Services online referral form. 

Requests can be submitted for a student to receive services.  It is not necessary to know which service you are asking for or which specialist would be most appropriate.  Just answer a few questions and we will take it from there.  The referral will go to the Eaton RESA Behavior/Mental Health Department, and we will review and assign the student as needed- this includes creating customized interventions.

Whether we need to reach out for more information or we begin the consent process, we attempt to review all referrals within 7 days and assign them to a specialist within 30 days.  Please note - the form is not intended for emergency or crisis situations. 

For assistance completing this form, please contact Heather Morehouse at 517.541.8941.

Referral Information
Participant Information
Student Gender
Does student have either of the following?   (required)
Parent/Guardian Information
Have the parents/guardian of the student been notified?   (required) Help for Have the parents/guardian of the student been notified? Please note...Referrals for youth under the age of 14 will not be processed until parent has been notified of the referral. Our team is unable to "cold call" families.
Please note...Referrals for youth under the age of 14 will not be processed until parent has been notified of the referral. Our team is unable to "cold call" families.
Referral Details
Tentative Referral Services Requested (check all that apply):   (required)
Security Check - To verify you are not a robot, please answer this question:
 


Contact Us
PowerSchool
Professional Development
Staff Directory
Find Us