Staff » Student Referral Forms

Student Referral Forms

Referral Forms

All forms are accesible below by clicking on the appropriate links below.

ISIS Student Discipline Referral Form
  • Print this form to send a student to the Deans Office for disciplinary reasons ONLY when the ISIS system is not operational.

Discipline Referral Hall Pass
  • Use this form as a hall pass to send a student from the classroom to the Deans Office. You should also complete an online Discipline Referral from the ISIS system (click here for ISIS).


IMPACT Staff Member Referral
  •  Deliver filled out forms to the Impact Office or send to the Impact Coordinator at tlp2695@lausd.net


Confidential Referral to Psychiatric Social Worker
  • This form can be returned via e-mail to guadalupe.alvarez@lausd.net or by using Jinger Alvarez's mailbox in the Main Office or her tray in the Counseling office in a SEALED envelope indicating the student’s name, grade and track. 


PSA Counselor Referral Form
  • This referral form can be returned to the PSA counselors box in the Main office or to the Attendance office