Parent/ Guardian Counseling Referral
SEED is pleased to offer supportive services to help your child develop the needed skills to be successful at school. These counseling services support SEED’s belief in providing each and every student with the opportunity to learn new skills and behavior to help them in their personal, social, and academic development. Counseling strengthens the SEED philosophy by providing a safe and positive place to grow.

Please remember that if you suspect abuse and/or neglect, you are a mandated reporter and required to notify CFSA. Completing this referral does NOT fulfill your legal obligation to notify CFSA. The phone number to report abuse and/or neglect is (202) 671-7233.

What is your child's first and last name? *
Your answer
What grade is your child in? *
Why are you referring your child for counseling services? Please select as many as apply. *
Required
How urgent is your referral for counseling?
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Crisis
Additional Information/Observations *
Your answer
What is the name of your child's Resident Advisor (RA) in the dorm? *
Your answer
Parent/Guardian Information *
Your answer
What is the best phone number to reach you? *
Your answer
What is a current email address to reach you? *
Your answer
What is the best time to call you? *
Your answer
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