Parent/Guardian Notification of Counseling Services and Consent for Use of Mental Health Screener  2025-2026 School Year - Liberty Hill High School | Liberty Hill ISD
EFFECTIVE SEPTEMBER 1, 2025

In accordance with newly passed legislation, the District must notify parents of school counseling services and give parents the opportunity to opt out before those services are provided to their child. Consent given through this form is effective during the current school year unless rescinded earlier.

School counseling services are more fully explained in board policy FFEA, and student mental health is covered in board policy FFEB. Information about threat assessments can be found in board policy FFB.

We are notifying you below of our Routine Counseling Services.

ROUTINE COUNSELING SERVICES

State law requires school counselors to provide the following services as part of a Comprehensive School Counseling Program:

  • A guidance curriculum to help students develop their full educational potential, including the student's interests and career objectives. Guidance lessons can be found on each campus website under the tab Parent and Students then Counseling Services

  • A responsive services component to intervene on behalf of any student whose immediate personal concerns or problems put the student's continued educational, career, personal, or social development at risk.

  • An individual planning system to guide a student as the student plans, monitors, and manages the student's own educational, career, personal, and social development.

  • System support to support the efforts of teachers, staff, parents, and other members of the community in promoting the educational, career, personal, and social development of students.

We are asking for consent to provide mental health related services, including screening your child for suicidal ideation if they express thoughts of self-harm.

As required by law, below is a copy of the screener that is routinely used by School Counselors, Licensed Mental Health Counselors, Interns or School Psychologists for your review.
  • The Columbia Suicide Severity Risk Screener is only used with individual students who are referred for possibly expressing suicidal thoughts or self-harm behaviors. Parents will also be contacted after the screening is complete.
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Email *
Student's Last Name *
Student's First Name *
Student's Grade-level *
Student ID Number (lunch number)
Acknowledgement of Notice *
Required
I wish for my child to receive Routine Counseling Services. 
A guidance curriculum to help students develop their full educational potential, including the student's interests and career objectives. Guidance lessons can be found on each campus website under the tab Parent and Students then Counseling Services

A responsive services component to intervene on behalf of any student whose immediate personal concerns or problems put the student's continued educational, career, personal, or social development at risk.

An individual planning system to guide a student as the student plans, monitors, and manages the student's own educational, career, personal, and social development.

System support to support the efforts of teachers, staff, parents, and other members of the community in promoting the educational, career, personal, and social development of students.

Clear selection
I give written permission for my child to be screened for suicidal ideation using The Columbia Suicide Severity Risk Screener. It is ONLY used with individual students who are referred for possibly expressing suicidal thoughts or self-harm behaviors. Parents will also be contacted after the screening is complete. *
Parent/Guardian's Last Name *
Parent/Guardian's First Name *
A copy of your responses will be emailed to the address you provided.
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