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Referral Forms

Referral Formsmindpeace2020-12-02T17:18:26-05:00

Referral Forms for CPS Schools

Please refer at-risk students who may need mental health services to your lead school-based mental health partner.  Click on your school below for the lead mental health partner’s referral form or link. If you need the contact information for sending a referral form, click here.  Please remember to contact the student’s guardian for verbal permission before making the referral.  Thank you!

Aiken
AMIS
AWL
Bond Hill
CANS
Carson
Chase
Cheviot
Clark Montessori
College Hill
Covedale
Dater High School
Dater Montessori
Ethel Taylor
Evanston- Partner TBD
Fairview-Clifton German Language School
Frederick Douglas
Gamble Montessori Elementary
Gamble Montessori High School

Hartwell
Hays-Porter
Hughes High School
Hyde Park
JP Parker
Kilgour
LEAP
Lighthouse School
Midway
Mt. Airy 
Mt. Washington
North Avondale Montessori
Oyler- Partner TBD
Parker Woods Montessori
Pleasant Hill Academy
Pleasant Ridge 
Rees E. Price
Rising Stars
Roberts Academy
Rockdale
Roll Hill
Roselawn
Rothenberg
Sands Montessori
Sayler Park
SCPA
Shroder
Silverton
South Avondale
Spencer Center
Taft Elementary
Taft High School
Virtual High School
Walnut Hills
Western Hills University High School
Westwood
Winton Hills
Withrow High School
Woodford
Woodward High School
Offices at the Cincinnati Children’s Hospital Medical Center’s College Hill Campus
5642 Hamilton Avenue | Cincinnati, Ohio 45224
513.803.0844 | info@mindpeacecincinnati.com
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