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Request Support Services

All counseling and 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.

DURING THE COVID-19 PANDEMIC

To keep our clients & clinicians safe, we provide secure and confidential Telehealth appointments. We are also here to provide individual & family services that can help improve overall health, well-being, and daily lives.

Our mission is to significantly enhance the lives of all youth to fulfill their potential as caring, productive, contributing citizens.

SCRAPBOOK

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