Counseling Permission Slip
Dear Parents/Guardians:

Elementary counseling services are provided to address issues that may be interfering with a student’s ability to focus on their academic progress. These issues may include but are not limited to the following: self-esteem, school success, interpersonal relationships, social skills, attitude toward school, decision making, effective problem solving, personal crisis in their life.

Parental permission is required in order for your child to receive counseling services. Please fill out the form below if you would like your child to be afforded this opportunity. You can view the LVUSD Counseling Services Consent Form here (https://rb.gy/xj033n).

Please email me (aasmerian@lvusd.org) with any concerns or questions you may have regarding this program.

I look forward to speaking with you and working with your child. I am confident this will be a positive and rewarding experience.

Sincerely,

Anika Asmerian
School Counselor
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Email *
Date *
MM
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Student's Last Name *
Student's First Name *
Grade *
Teacher *
Parent/Guardian First and Last Name *
Parent/Guardian Phone Number *
Counseling Permission (NOTE: This question serves as a digital signature) *
A copy of your responses will be emailed to the address you provided.
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