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Parent to Counselor Referral Form
This form is for parents that have concerns about their student at Yantis ISD. Please remember that you will only be contacted if there is a serious threat with your student.
Students Name *
Last Name, First Name
Your answer
Parents / Guardian Name *
Last Name, First Name
Your answer
Academic Reasons for Referral
Check all that apply
Social/ Emotional Reasons for Referral
Check all that apply
He/ She needs to see you... *
I would like for you to see them... *
Any other helpful information, please share here.
Your answer
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