• Student Referral Form

    This referral form is for use by Roseville Adult School students who are in need of support from a school counselor for themselves or a person they are concerned about.
    PLEASE NOTE: If you or someone you know is in a LIFE-THREATENING SITUATION or experiencing a mental health crisis or emergency, please stop completing this form and CALL 911 IMMEDIATELY.

    You can also find Suicide Hotlines and other 24-hour Crisis Intervention help at: https://www.suicideispreventable.org or by calling 1-800-273-8255.