Parent/Caregiver Request to Speak with the School Counselor
Complete the following request to check in with the school counselor. Requests will be sent via e-mail to Mrs. Clark, Monday-Friday 8 AM - 3 PM. Parents who submitted form will be contacted within 24 hours.

***Please note that this request is for non-emergencies only. If it is an emergency (safety concern or life threatening situation), do NOT email your School Counselor. Call 9-1-1 if you have immediate concerns for a child's safety and/or believe they are victims of abuse.

Additional Resources:

Crisis Text Line: Text "LA" to 741741
Department of Mental Health: 1-800-854-7771
National Suicide Hotline: 1-800-273-8255
Trevor Project Lifeline (Available 24/7; Confidential Suicide Hotline for LGBT Youth): 866-488-7386

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Parent Name (First, Last) *
Telephone Number
Email Address
Student Name *
Grade *
Contact Preference
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Best Time to Contact You
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Reason for Referral *
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Immediacy of referral
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Any additional Information/Comments
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This form was created inside of LANCASTER SCHOOL DISTRICT. Report Abuse