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School Counseling Referral for Parents
Greetings parents! Please complete this electronic form if you would like for the school counselor to work with your student.
Student Name (First and Last)
Please share your concerns and reasons for your referral.
Who have you contacted previously about your concerns?
I contacted his/her teacher
I contacted the principal/assistant principal
I haven't spoken to anyone about my concerns yet
Level of Urgency
As soon as Possible
Sometime this week
Within the next 2 weeks
How would you like me to follow up with you after meeting with the student?
Let's schedule an appointment to meet in person
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