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This form is for staff to refer students for an intake with Cartwheel. Please secure parent/guardian consent for the referral to Cartwheel before filling out this form.
After a referral is approved by your school leadership, Cartwheel will contact the family to schedule an intake appointment.
Please note: Cartwheel does not provide urgent or emergency care. In case of a medical or psychiatric emergency, please call 911 and ensure the student is brought to the nearest emergency room. If you have any questions about Cartwheel, please contact your school admin or your dedicated Cartwheel Program Manager.
If you have any questions about Cartwheel, please contact your school admin or your Cartwheel Program Manager.
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