Elementary School Counseling Parent/Guardian Referral Form
The school counselor (Mrs. Tegge) is available to talk with students or consult with parents for a variety of issues you may face throughout the school year. School counselors typically offer short-term counseling (about 3 sessions), and refer out with parent permission based on perceived parent need. If you would like for your student to meet with the school counselor, please fill out the following form.
**PLEASE NOTE: If this is an emergency, and the student is stating they want to hurt themselves or others; or if you suspect child abuse/neglect please call either 911 or report to Perry County Children Services(740) 342-3836. Requests are not processed immediately and may be reviewed up to two days following the request submission. All school personnel are mandated reporters and are obligated to report issues of suspected child abuse/neglect.**
Confidentiality notice: This form is confidential, and Mrs. Tegge will endeavor to keep the information between you, her, and the Google form collecting system. However, confidentiality cannot be guaranteed while the form is unsubmitted. Your email address will be submitted upon the completion of this form as an optional contact point for Mrs. Tegge to reach you.