Request Support Services

All counseling and social support services are provided at no-cost to any SMMUSD child, their family, and the community at large. Services can be requested by filling out a form below or by contacting Wellness Staff directly.

Phone: 310-457-6801 ext 74141
wellnessinfo@bgcmalibu.org

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STUDENT REFERRAL FORM

To inquire about our services or submit a referral on behalf of a student (ie school-based staff)
 
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PARENT / GUARDIAN INTAKE FORM

For parents or guardians requesting services for a child.

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INDIVIDUAL INTAKE FORM

For adults & community members who are ready to begin services.

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OLDER ADULTS INTAKE FORM

For seniors in our community who are requesting services.

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FORMULARIO DE REFERENCIA PARA ESTUDIANTES

Para consultar sobre nuestros servicios o enviar una referencia en nombre de un estudiante.

FORMA DE ADMISION PARA PADRES O GUARDIANES

Para padres o guardianes solicitando servicios para un niño o niña.
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FORMA DE ADMISION INDIVIDUAL

Para adultos y miembros de la comunidad que están listos para comenzar servicios.
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FORMA DE ADMISION PARA ADULTOS MAYORES

Para adultos mayores en nuestra comunidad que solicitan servicio.

TELEHEALTH OPTIONS AVAILABLE

We provide secure and confidential Telehealth appointments. We are here to provide individual & family services that can help improve overall health, well-being, and daily lives.

SCRAPBOOK

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