St. Marcus Counseling Referral Form 2023-2024
Counseling MAY be beneficial for students who struggle with:
  • Behavior
  • Emotions
  • Peer Relationships
  • Family Changes
  • Academics
  • Motivation
  • Social Skills
  • and a variety of other life situations.

This form is to be completed by a parent/guardian.
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Counseling Referral Procedure
  1. Complete this online referral form.
  2. A counselor with Christian Family Solutions (CFS) will collaborate with you about your concerns and discuss the options available for your student.
  3.  A counselor with Christian Family Solutions (CFS) will complete a classroom observation and/or communication with Special Education/Deans/Directors about level of intervention needed and/or available for the student.
  4. Communication/Collaboration with teacher regarding intervention plan & data tracking. *If individual counseling or small group intervention is decided upon: a) Teacher may complete a referral as well (if applicable), b) Corresponding permission forms will be sent home & need to be returned before counseling can begin, c) Strengths and Difficulties Questionnaire completed by teacher/parent/student (if applicable) d) A counselor will coordinate counseling schedule in collaboration with classroom/student schedule & communicate with teacher/adviser.
  5. Follow-up communication between the teacher, advisor, counselor, parent, and admin will be expected throughout the intervention.
*Note: Some steps may change depending upon severity and/or historical needs of an individual student.
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