2026-27 Grand Ledge School-Based Health Center Behavior/Mental Health Services Referral Form

The 2026 - 2027 Grand Ledge School-Based Health Center Behavior/Mental Health Services Referral Form can be completed at any time to submit a request 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.

Participant's sex
Participant gender identity
Is Participant a minor?   (required)
If yes, does a parent/guardian know that services are being requested?   (required)
Parent/Guardian Information
Referral Details
Tentative referral services requested (check all that apply):   (required)
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