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Salem Elementary School COUNSELING REFERRAL FORM FOR PARENTS Date Students name Grade School Teacher Referred by (your name) Reason(s) for referral: Motivation Bullying Swearing Divorce Fighting Worries

How to fill out school counseling referral form

How to fill out school counseling referral form

1. Step 1: Obtain a copy of the school counseling referral form from your school's guidance office.
2. Step 2: Fill out your personal information accurately and completely, including your name, grade level, and contact information.
3. Step 3: Specify the reason for seeking counseling and provide as much detail as possible. Explain any specific concerns or issues you are facing.
4. Step 4: Describe any previous counseling or therapeutic services you have received, if applicable.
5. Step 5: Provide information about any medications you are currently taking or any medical conditions that may be relevant to your counseling needs.
6. Step 6: Indicate any preferences you have regarding the counselor's gender or any specific counselor you would like to be referred to if applicable.
7. Step 7: Sign and date the counseling referral form, indicating your consent to receive counseling services.
8. Step 8: Return the completed form to the guidance office or the designated personnel as instructed.
9. Step 9: Follow up with the guidance office or counselor to confirm that your referral form has been received and to schedule an appointment, if necessary.

Who needs school counseling referral form?

1. Students who feel the need for professional guidance and support in dealing with personal, academic, or social-emotional issues may require a school counseling referral form.
2. This form may be needed by students experiencing difficulties such as academic struggles, bullying, relationship problems, substance abuse, mental health concerns, or any other personal issues that may impact their wellbeing and educational experience.
3. Parents or guardians may also need to fill out this form on behalf of their child if they notice signs of distress or if they believe their child would benefit from the services provided by a school counselor.

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What is school counseling referral form?

A school counseling referral form is a document used by educators or parents to refer a student for counseling services, indicating the need for support regarding academic, emotional, or social issues.

Who is required to file school counseling referral form?

Typically, teachers, school staff, or parents are required to file the school counseling referral form when they identify a student in need of counseling support.

How to fill out school counseling referral form?

To fill out a school counseling referral form, one must provide the student's personal information, describe the concerns or issues that prompted the referral, and include any relevant background information.

What is the purpose of school counseling referral form?

The purpose of the school counseling referral form is to formally document the need for counseling services, facilitating timely intervention and support for the student's well-being.

What information must be reported on school counseling referral form?

The information that must be reported includes the student's name, age, grade, specific concerns or issues observed, and any relevant history that may assist the counselor in addressing the student's needs.