'20-'21 Wellness Screener: Opt-Out Form
In an effort to be more proactive in supporting students’ mental health, a wellness screener will be given to all students at Da Vinci Connect HS next week. Results from the screener will be used by the counselors to create interventions such as coping skills groups, counselor check ins, and referrals for therapy.

Scores will not be shared with students or parents. Parents will be notified and parent consent is required if a student is referred and receives receives counseling services delivered by Antioch or Pepperdine therapists. If you would like your child to OPT-OUT and NOT PARTICIPATE in the screener, please fill out this form by Sunday, November 8, 2020.
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Student's Name (Last, First)
Student's Grade Level
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Parent/Guardian Name (Last, First)
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