When to Refer
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Test or speech anxiety
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Excessive procrastination or poor preparation
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Attention/memory difficulties
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Repeated requests for extensions
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Isolation from others
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Dramatic weight loss/gain
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Attendance decline
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Outburst of anger
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Chronic fatigue/low energy
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Restlessness
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Changes in personal hygiene
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Alcohol/drug abuse
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Suicidal/homicidal threats
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Low self-esteem