Counseling Referral Question Title * 1. What insurance do you have? Medicaid Private Non-Medicaid I don't have any Question Title * 2. Do you have a preference of which agency? If so, please list. Chrysalis BayCare HEADS Sequel Lifespan I need help deciding I want the school social worker or counselor at Cypress to meet with my child Question Title * 3. Would you like in person or virtual? In Person Virtual Question Title * 4. This is my child's name or student ID # Question Title * 5. This is my name Done