El Dorado Parent/Guardian Counselor Request Form
Please complete the following questions below if you would like to discuss any concerns regarding your child in ensuring their best learning success while at El Dorado Elementary.
If this is URGENT due to a safety concern, you may contact the front office at (661) 942-8487 and request to speak with the school counselor- Mrs. West.
Please provide your preferred contact number or email address to receive a response from the school counselor
Week Days that Work Best for a Meeting (Please choose more than one)
Area of Concern (If other please provide a short description)
Academic Concern (Grades, Goal Setting, Organization, Time Management, or Study Skills)
Attendance Concern (School Refusal, Challenge 5, Attendance Letter, or Independent Study)
Crisis Concern (Self Harm, Threats, or Suicidal Ideation)
Emotional Concern (Sadness, Anger, Isolation, Trouble Sleeping, Anxiety)
Situational Concern (Death, Divorce, Separation, Deployment, Deportation, Homelessness)
Student Services Meeting (SST, 504, Crisis Follow Up, or IEP)
Social Concern (Bullying, Cyber-Bullying, Gang Affiliation, Peer Conflict)
Requesting Information about School Based Mental Health (SBMH) services
Never submit passwords through Google Forms.
This form was created inside of LANCASTER SCHOOL DISTRICT.
Terms of Service