Consent & Referral Authorization Forms

Parental Consent for Individual and Small Group Counseling

• Printable Form: Parent Permission Slip

Student Request for Counseling Support

• Digital Form: Student Request for Counselor (Self-Referral) 

Kennedy Staff: Student Referral For Counseling Support

• Digital Form: Referral for Individual Counseling

• Digital Form: Referral for Group Counseling

Restorative Practices

• Digital Form: Request Counselor Facilitation of Restorative Circle within the Classroom (Proactive or Responsive)

• Google Calendar: Appointment Schedule (to Book a time for Counselor Facilitation of RP Circle within the Classroom)

• Digital Form: Teacher Facilitated Community Circle Reflection

  • Link: Restorative Practices: Circle Questions  

• Digital Form: Documentation of Teacher Facilitated Restorative Circle 

  • Handbook: Restorative Circle Topics

Lunch Bunch

• Digital Form: Student Nomination