True North Referral

True North Student Assistance & Treatment Services

Please correct the errors described below.

Referrals may take up to five business days to process. For faster service, contact the Intake Line, Monday - Friday, 8 am – 5 pm. If you or your child is in crisis and need immediate assistance, please call the Crisis Services Hotline.

Intake Line: 360-464-6867
Crisis Line: 800-270-0041

Date of Referral

Your Name

Relationship to Student

Your Phone Number

Your Email

Student/Family Information

Student's Name

Student's Age

School

Service Region

Parent/Guardian's Name

Can we contact parent/guardian?

Yes No

Referral Details

Referral Type

Disciplinary

Concern

Youth/Family Requested

Substance Use

Mental Health

Other/Unknown

Reason for Referral

Follow Up

Are the student and parent/guardian aware of this referral and expecting to hear from us?

Yes Student Only Parent/Guardian Only No

If there is a specific True North counselor you would like to be notified of this referral, please enter their name below.

Your information will be encrypted.

Referrals may take up to five business days to process. For faster service, contact the Intake Line, Monday - Friday, 8 am – 5 pm. If you or your child is in crisis and need immediate assistance, please call the Crisis Services Hotline.

Intake Line: 360-464-6867
Crisis Line: 800-270-0041

True North Student Assistance & Treatment Services

360-464-6867 (Intake & Scheduling), 360-533-9749 (Grays Harbor Office), 360-748-2274 (Lewis Office), 360-427-2050 (Mason Office), 360-942-2474 (Pacific Office), 360-464-6867 (Thurston Office)
www.truenorth113.org

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