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LSC - Referral Form

Student Information

Need assistance?

Fill out this form and a CIS team member will respond to your request within two business days. 

CIS hours are Monday through Friday 8:00 am - 4:00 pm. We are closed on all school holidays.

This form is NOT for emergencies. In case of an emergency, please contact 911

Thank you for contacting Communities In School of Houston.
This question requires a valid email address.
7. Please let us know what you need help with. Feel free to select multiple boxes.  *This question is required.
10. Please sign:  *This question is required.
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