MNHHS Youth Services Center Parent Referral
Do you have a concern about your student?  Do you have an issue in the household you need assistance with?  Do you need help, but don't know the best way or where to start?  Use this referral form and the Youth Services Center will direct your needs to the appropriate school staff for support.  
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What is your (parent) first and last name? *
Best phone number to reach you? *
What is your student's first and last name? *
What grade is your student in? *
Is your reason for contacting us: Academic Concerns? *
Is your reason for contacting us: Personal issues? *
Is your reason for contacting us: Financial issues? *
Briefly tell us more information regarding your reason for contacting us. *
Would you like a follow-up contact from the MNHHS Youth Services Center staff? *
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