Drug Addiction Counseling Referral

Hi, friend! Sign up or sign in to Wufoo to use this form. Not what you're looking for? We've got 400+ templates to choose from.

cloud cloud cloud cloud

Drug addiction is one of the greatest concerns in our society today - especially among students. Share our online Drug Addiction Counseling Referral with your staff and student body so that they can refer fellow students who they believe have or are in danger of having an addiction to drugs. Provide prompt and appropriate guidance and counseling - or if necessary, referral to a drug rehab center for more in-depth addiction treatment. Our online form can be fully customized to meet the particular needs of your school or student body.

What's in the Drug Addiction Counseling Referral?

Launch this form as-is or customize it to your heart's content!

Use This Form

Whether you are a school administrator, school psychologist, school counselor, or school teacher, you have probably witnessed the damage that drug addiction can have on your students and their families. Use our online Drug Addiction Counseling Referral template to solicit referrals regarding students that may be struggling with addiction. Collect the name of the referring party, their contact information, and the referred student's name and age. Get a full description of the addiction history and/or specific concerns. Swift action can make all the difference in a student's life!

You may also like:

Child Behaviors

If you work in education, send our online child behaviors form to parents to get a better understanding of your students’ habits. Our easy-to-use form is designed for parents or caregivers to fill out, and it asks questions related to a child’s behavior when they’re not at school.

VIEW FORM TEMPLATE   

Parental Support

If you are a teacher, school administrator, or educator, send out our parental support survey to learn more about how parents are interacting with (and supporting) their children. The easy-to-fill out form asks parents questions relating to the type of care they are offering their children.

VIEW FORM TEMPLATE   

Social Support

If you work closely with parents and children, send parents our online social support survey to learn how much support they’re giving their children. Our easy-to-use form helps you understand more about their children’s social interactions--so you can better understand your students.

VIEW FORM TEMPLATE   

Healthcare form templates

Browse our 400+ online form templates or click any of the healthcare form templates below to start using it immediately after you sign up or sign in.

Trusted by some of the most popular brands on the web.

Let's make it official

We want to give you our everything (and more if you need it).

Not ready to commit? Try before you buy.

Create a Wufoo account today to build 
3 forms for FREE