This form is intended for parents/guardians to refer their son/daughter for school counseling at Scholarship Prep. School Counseling services are provided virtually once a week for 10-30 minutes for individual counseling ranging from 4-5 weeks and group counseling ranging from 6-8-weeks.

When referring and signing a consent form, parents/guardians understand that the school counselor or school counseling staff (school counseling assistants/ interns) will keep information confidential. However, exceptions to confidentiality occur in certain cases when there is reasonable suspicion of child abuse, cases of danger to one’s self, and/or cases of danger to others. Your child will be made aware of these limits to confidentiality by the school counselor and/or counseling staff (school counseling assistants/ interns). Parents understand that the counselor and/or school counseling staff may choose to consult with other professionals, teacher(s), administrator(s) or school staff on a need to know basis, so that they can better assist their child as a team.

Please note that even if a referral is made, counseling services cannot be completed without parent/guardian consent. Consent forms will be sent home after the Counselor has spoken with the parent/guardian.