Request edit access
WSD School-Based Counseling Referral Form
The Marathon County School-Based Counseling Consortium comprises of nonprofit and for-profit mental health
clinics, public school districts, and community organizations. Consortium counseling agencies are able to provide on-site mental health counseling to students in all Marathon County public schools.
If you would like to refer your child for school-based counseling or would like more information, please complete the questions below and a representative from your child's school will contact you.
Sign in to Google to save your progress. Learn more
Date: *
MM
/
DD
/
YYYY
Student Name *
School *
Parent/Guardian Name *
Parent/Guardian Contact Information - phone number and/or email *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Wausau School District. Report Abuse