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School Counseling Referral Form By Parent(s) or Guardian(s)Students Name: Grade: Referred by: Homeroom: Phone #: Relationship to student: Reason for referral: (check all that apply) Academic Low grades/Failing
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Step 1: Gather all necessary documents and information.
02
Step 2: Start by filling out the personal information section, including the child's name, date of birth, and contact details.
03
Step 3: Provide all required details about the child's health history, allergies, and any special needs.
04
Step 4: Fill in the emergency contact and authorized pickup information.
05
Step 5: Complete any additional sections or forms that are specific to your situation, such as medical consent or dietary restrictions.
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Step 6: Review the filled-out form for accuracy and completeness before submitting it.
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Step 7: Submit the completed form to the appropriate recipient or authority, following any specified instructions.

Who needs by parents or guardians?

01
Parents or guardians of children who are enrolling in a school or educational institution.
02
Parents or guardians of children participating in extracurricular activities or summer camps.
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Parents or guardians of children attending daycare or preschool.
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Parents or guardians of children requiring medical or special needs care.
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Parents or guardians of children traveling or going on field trips that require permission forms.
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By parents or guardians refers to a process where parents or legal guardians take responsibility for certain legal or financial matters on behalf of their minor children or dependents.
Parents or legal guardians are required to file by parents or guardians on behalf of their minor children or dependents.
By parents or guardians can be filled out by providing relevant information about the minor child or dependent and signing the necessary forms or documents.
The purpose of by parents or guardians is to ensure that legal or financial matters are properly managed on behalf of minor children or dependents who are not able to do so themselves.
Information such as the minor child's or dependent's personal details, financial information, and any relevant legal documents may need to be reported on by parents or guardians.
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