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Form 2 - Psychiatric Consultation


Psychiatric consultation is provided to help rule in or out the presence of a psychiatric disorder, which affects a student's education.

Professionals involved in the referral must have discussed the student's case and have adequately used their own resources prior to initiating a referral for formal consultation. Sending appropriate personnel who have knowledge and experience with the student to the evaluation is required. All documents listed below must be included in the referral packet.


Consultations are scheduled, based on need and the availability of the psychiatrist . The time between a completed referral, consultation, and completed report usually does not exceed three to four weeks.

Referral Process:

  1. Form 2, with signatures of the Director of Special Education and the parent is forwarded to the Director of the MISD Assessment Center with special attention given to:
    - Daytime, work, cell phone numbers of parents and referring person are critical for prompt processing;
    - Indication as to whether or not the child has been previously seen at MISD.
  2. The following must be included:
    0 -- Current Eligibility Report(s)
    0 -- Current IEP
    0 -- Current REED Report(s)
    0 -- Current Academic Testing
    0 -- Anecdotal Records
    0 -- Interim Report (if time lapsed between referral and consultation)
    0 -- Cover letter Clearly Stating Problem and Expectations
    0 -- Current comprehensive psychological/WISC III Scores with all subtest standard scores (within last year)
    0 -- Detailed Social/Medical/Academic Histories including family status, medical history and academic history (completed within the past year), including any medical records, medication history, psychiatric records, treatment dates, etc.
  3. Forward completed referral packet to MISD Director of Assessment Center.

NOTE: Incomplete referrals will be returned to the Director of Special Education or MISD building administrator with specific notation as to what is missing and will delay the process.

Referral Response:

  1. The referral packet is reviewed at the MISD. If complete, and determined to be a clinically appropriate referral, the district is contacted by telephone and a date for the evaluation is determined. It is the district's responsibility to set appointment with parent.
  2. No appointments are scheduled before all required information has been provided.

A letter is sent to the parent and district confirming the date, time and doctor who will conduct the consultation. If the appointment was scheduled as an emergency, the parent/district may not receive notification by letter.

  1. A representative of the school district familiar with the case, the parent and the child must be present for the evaluation.
  2. All parties may be interviewed at the doctor’s discretion.
  3. A verbal summary and recommendations are given at the conclusion of the consultation.


Within 3 to 4 weeks, a written report of the consultation will be sent to:

  • Parent
  • Director of Special Education

Any suggested follow-up that may be recommended by the psychiatrist as a result of this consultation is done privately at the discretion and expense of the parent/guardian.


If an emergency consultation is necessary, the above procedure may not be strictly followed.

Form Links:

Form 2 signed by Parent and Special Education Director

Updated: August, 2019