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Welcome to the Student Wellness and Support Services School Counseling website where SBCUSD Shines!

SWSS School Counselors
School Counseling
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School Counseling

Forms

Suicide Intervention Forms (2246)

Referral Forms

Suicide Intervention Forms

This Student Suicide Intervention Flowchart (download here) outlines procedures to be followed when a suicide attempt, threat or disclosure is reported. (2022-23 Suicide Risk Assessment & Intervention training slide deck and video)

In addition, please see below for student suicide...

  • Intervention checklist

  • Risk assessment questions

  • Risk factors / warning signs

  • Parent notification forms (English / Spanish)

  • Re-entry self-care plan

  • Risk evaluation protocol in a virtual environment

  • Postvention strategies

Suicide Risk Assessment & Intervention training '24-'25 slides

intervention checklist

Intervention Checklist

suicide risk assessment questions

Risk Assessment Questions

suicide risk factors and warning signs

Risk Factors / Warning Signs

Suicide Parent Notification Form
(English / Spanish)

Re-entry Self-Care Plan

Logging Procedures

Self-Injury Parent Notification Form (English / Spanish)

virtual suicide assessment protocol

Risk Evaluation Protocol in a Virtual Environment

Support Program Flowchart for Counselors

Referral Forms

Use the links below to download forms for

  • Victor Community Support Services (VCSS)

  • Release Authorizing Disclosure of Protected Information

  • IEHP Health Navigators

  • Other Tier 3 Service Referrals

VCSS Referral Form

Authorization for Disclosure of Protected Information

Additional Tier 3 Services Referral Forms

VCSS Group Partic. Consent

IEHP Health Navigators Referral 

sample email,
flyer (Engl. / Span.)

For information on this website, please email swsscounselingprojectteam@sbcusd.k12.ca.us.


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