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School Counseling Agreement Form

Please complete the fillable referral form below and fax the completed copy to 715-848-0425. It is intended for either school personnel or parents to complete on behalf of students. If you prefer to fill out the form by hand, please print it and fax the completed form to 715-848-0425. Thank you!

School Based Services

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appointments@bhclinic.com
855-607-8BHC (855-607-8242)

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