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Counseling Referral Form Template

You can use this simple counseling referral form template to obtain a brief description of drug addiction history from your students.

AVAILABLE ON FREE PLAN

This template is available in the FREE plan, with many perks:

100 submissions per month
Digital signatures
Use your own logo and branding
Share and publish it anywhere
Notification emails

Continue with template

Join 1.5 million happy customers that build forms & surveys with 123FormBuilder

Customize template

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Modify this counseling referral form template with simple drag-and-drop and other configuration features provided by the 123FormBuilder form building engine. Once you've copied the form template in your 123FormBuilder account, you can start personalizing it.

Publish template

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You can embed the counseling referral form on the school's website or share it with other people via its link. The publishing code and link are immediately generated in the publishing section. From there, you can just copy it and paste it where needed.

Collect & manage data

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All information is carefully stored in a database that comes with this counseling referral form. There you have full access to manage your data as you please. You can filter the datatable for a certain student and review his/her history and other details that have been filled in the form.

Optimize your flow

See how

Copy this online counseling referral form template in your 123FormBuilder account to use it. If you don't have an account, just click the button to get one. The above form template will be automatically duplicated in your drag-and-drop editor after doing so.