Parent/Legal Guardian Referral Form for DES Counseling Services 2025-26
Complete and submit this form if you are requesting counseling services for a student during the 2025-26 school year.
Sign in to Google to save your progress. Learn more
Student's First Name     *
  Student's Last Name *
Student's grade *
Name of Student's teacher *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lebanon City Schools.

Does this form look suspicious? Report

Google Forms