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Counselor Referral Form - PARENTS & TEACHERS
This form is available for parents and teachers to refer a child to be seen by the counselor.
I would like to refer a child/student to the counselor regarding:
health and wellness
Any more information you would like to add:
an emergency (seen as soon as possible)
is very important (seen within a day or two)
can wait (a couple of days)
This form will be sent directly to Mrs. Ryals
Mrs. Ryals is typically on campus Tuesday through Friday. She can be reached at
or by calling the front office at (805) 771-1858
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This form was created inside of San Luis Coastal Unified School District.
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