MD Handle With Care Notification Report

Maryland Handle With Care Notification Report
Name*

First NameLast Name
Email*
example@example.com
Select Month/Year Reporting*
County Reporting*
Number of notices sent*
Number of students affected*
Number of students referred to mental health services within the school
Number of students referred to mental health services outside of the school
If mental health referrals are zero, please indicate below if there were no mental health referrals this month or if the data was not collected.
Mental Health Referrals
Number of notices sent by agency
Please use the space below to provide general feedback and success stories.
General Feedback
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Maryland Handle With Care Notification Report