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Mesa Linda Middle School 2020-2021 Counseling Referral Form
If you are a student or a parent/guardian of a MLMS student and would like to talk to a member of the counseling team, please complete this form letting us know a little about what's going on and one of us will get back to you as soon as possible.
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Name: *
Relationship to Student: *
Required
Email: *
Reason for Referral:
If this is an EMERGENCY and you do not have immediate access to a counselor, please speak to a trusted adult ASAP, call 911, or call the Suicide Prevention Lifeline at 1-800-273-8255.
*Please keep in mind that confidentiality will be difficult for counselors to maintain over Phone, E-Mail, or Zoom.
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