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Parent Referral for School Counseling
If you would like to refer your child to meet with Mrs. Schiedel-Anderson, please complete the form below. Counseling sessions are confidential except in the case of harm to self or others.
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Email
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Your email
Your Name:
*
Your answer
Student's Name
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Your answer
Teacher's Name
*
Your answer
Best Phone Number
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Your answer
Is your child currently working with a mental health professional outside the school environment?
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Yes
No
Other:
I am referring my child for counseling services because: (example- Anxiety About Return To In-Person Learning, Sadness/Anger, Social Skills, Family Issues, Friendship, Grief, etc.)
*
Your answer
After you submit this form, Mrs. Schiedel-Anderson will contact you. Please share any additional information that would be helpful for her to know.
Your answer
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