LRMS 6th-8th Grade 26 - 27 Counseling Referral Form

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If you are a student, parent/guardian, or staff member, you can use this form to let us know a little about what is going on and we will follow up. Once completing the form, Mr. Bogiatzis, Mrs. Burke, or Mrs. Morgan will contact you to meet and discuss your counseling referral.

Si eres un estudiante (o padres/guardianes de un estudiante) y quieres hablar con Mrs. Burke, Mrs. Morgan, or Mr. Bogiatzis (la consejera de la escuela), puedes usar esta forma para informarnos un poco sobre lo que pasa y nos pondremos en contacto con usted pronto.

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Please note (Tenga en cuenta)

This form is not monitored 24/7. If you or someone you know is in danger from self or others, please do not fill out this form. You should immediately talk to a trusted adult, call the Suicide Prevention Lifeline at 1-800-273-8255, call 911, or go to the nearest emergency room.

Este formulario no se controla las 24 horas del día, los 7 días de la semana. Si usted o alguien que conoce está en peligro para sí mismo o para los demás, no complete este formulario. Debe hablar de inmediato con un adulto de confianza, llamar a la Línea de Ayuda para la Prevención del Suicidio al 1-800-273-8255, llamar al 911 o ir a la sala de emergencias más cercana.

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