Use this form to refer your student to school-based counseling services. Please allow 5-7 school days for your request to be processed. Once the form is received, you will be contacted about potential services.

You can review the referral criteria here. 

This is not an emergency response service. If this Is an emergency, please contact 988 (Crisis Mental Health Hotline) or 911. 

Please keep in mind that:

• Not all students referred will receive school-based services. Please refer to the referral criteria on the counseling menu. 

• School counseling is brief and solution-focused, typically lasting 1 to 8 sessions.

• Parent permission is required for Tier 2 and 3 counseling services.

If students qualify for school-based counseling services, parental consent will be needed before starting sessions. You can access the parent consent form here. 

Parental consent is required before a student may participate in individual or group counseling services.

Informed consent is not required for restorative circles or check-in requests.

Click here for the paper form.

Click here for the Google Form.