FPS-Parent/Caregiver Referral
Thank you for reaching out so we can help support you and your student/students.

IF THIS IS AN EMERGENCY and your child or a child you know is in immediate danger to themselves or others call  911 or take them to the emergency room immediately. If you are worried about the safety or possible abuse of a child contact our local Department of Social Services at 410-713-3900 or click this link below for Wicomico County Dept. of Social Service website:
http://www.chamberdata.net/webforms/wicomico-county-dept-of-social%20services__1_685_5007861_memberprofile.aspx?dbid2=mdsal

* If you have more than one student in need of services, please fill out this form for each student.

 
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Email *
Learn more about school counseling:
Grade level of child/children: *
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Teacher Name: *
Student Name *
Your Name *
Best Phone Number (please enter (xxx) xxx-xxxx) and time to call: *
I need help: *
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Could you please... *
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Who would you like to contact you? *
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