Counselor Recommendation Form
Please answer the following questions to the best of your knowledge. Your answers will be kept confidential and will not be shared with the student or parents.
Student Last Name *
Student First Name *
Counselor Name *
Which of the following could be identified as the student need (mark all that apply)? *
Required
SVHS staff have had a conversation with this student's parent/guardian about transferring to SCHS? *
Academic Functioning (Please rate the student) *
Lowest
Highest
Comments regarding academic functioning:
Social Skills *
Lowest
Highest
Comments regarding social skills:
Maturity *
Lowest
Highest
Comments regarding maturity:
Family Situation *
Lowest
Highest
Comments regarding family situation:
Does the student currently receive any of the following services? *
Are there any safety concerns/considerations that we should know about including threat or lethality assessments, child abuse reports, behavior plans, etc.? *
If yes, briefly describe. Please also include the best person to contact on your staff to receive further information.
Has the student had attendance issues? *
Has the student had behavior issues? *
If yes to attendance or behavior issues, please explain.
Thank you! If you have any additional information please provide it below.
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This form was created inside of Lincoln County School District #2. Report Abuse