Student Referral Form

Who Should Fill Out This Form

This referral form may only be completed by school staff or authorized members of TAMMIRA partner organizations.

Important – Do Not Use This Form in Emergencies

Please do not refer students who are experiencing:

  • Acute psychosis
  • Risk of harm to themselves (suicidal) or others (homicidal)
  • Any immediate crisis or life-threatening situation

Instead, call 988 right away for emergency support.

About TAMMIRA’s Services

TAMMIRA provides psychoeducation and early prevention screenings. Our registered nurses offer guidance on topics such as mental wellness, diabetes care, and medication safety. However, they do not diagnose medical or mental health conditions or prescribe medication.