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Spring 2024 Wellness Screener: Opt Out Form
In an effort to be more proactive in supporting students’ mental health, a wellness screener will be given to all students at Da Vinci Design HS. Results from the screener will be used by the counselors to create interventions such as coping skills groups, counselor check ins, and referrals for therapy.
Scores will not be shared with students or parents. Parent consent is required if a student is referred to receive counseling services delivered by Antioch or Luminarias therapists. If you would like your child to
OPT-OUT
and
NOT PARTICIPATE
in the screener, please fill out this form by Monday, February 5, 2024
Be well,
DVD Counselors
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* Indicates required question
Student Name (Last, First)
*
Your answer
Student Grade Level
*
9
10
Option 3
12
Parent Name (Last, First)
*
Your answer
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