Mental Health Consultation Request Form
If you have concerns about your child's mental health and you are wondering about mental health supports that may be available at school or in the community, you are welcome to complete and submit this form. One of our mental health staff will contact you to follow up.

The SMCDSB does not provide crisis service through this platform. These requests will be monitored and you can expect a response within 3 days. If this is a crisis or you require urgent support see SMCDSB website > Mental Health and Well-Being > Community Mental Health Resources > Urgent Services.
Date of Request *
Parent/Guardian First and Last Name *
Parent/Guardian Email Address *
Do you give us permission to contact you by email? *
Parent/Guardian Phone Number *
Do you give us permission to contact you by phone? *
Name of your child's school *
NOTE: If your child is in the Simcoe Muskoka Catholic Virtual Elementary School, please select their HOME SCHOOL from the list below.
For parents of highschool students: I understand that the Guidance staff at my child's school may be contacted to assist with follow up. *
Please provide a brief description of your question or concern regarding your child's mental health? *
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