Parent Referral Form
This form is for parents/guardians to request counseling services. Any information shared on this form is for the use of the school counselor and will NOT be kept in any cumulative files.

If the basis for your referral is to report any abuse, neglect, or intent to harm, you should NOT fill this out and should instead contact the Texas Department of Family and Protective Services at 1-800-252-5400.
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