Lesslie Counseling Referral Form
Staff & parents, please complete this form to refer a student to see the school counselor.
*Just a friendly reminder that school counseling is not therapy, and is intended to be brief and solution-focused.
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Student's Name *
Grade Level *
Classroom Teacher *
Reason for referral *
Required
Briefly describe your concerns. *
He/she needs to see you... *
Referred by: (if by parents, please include contact info) *
Comments
Anything that would be helpful for me to know ahead of time.
Submit
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