Counseling Referral Form
Please use this form to request to see a School Counselor or to make a referral to a School Counselor.  Your response to this form will be seen within 2 school days and your School Counselor will follow up with you. Please note: this is not intended to be used in the case of an emergency.  If you need immediate help before or after school hours, please call 911 or Region Ten at 434-972-1800.
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