Counseling Referral Form for Parent Concerns
***THIS FORM IS CONFIDENTIAL***

Hi! My name is Mrs. Katie McKinney and I am the School Counselor here at WMS. I am SO excited to be here! I am looking forward to continuing to meet all of the students and their families.

This form should be used for non-emergency or non-crisis concerns only. If you are concerned about a students well-being, safety, or if you believe they are in need of immediate intervention please do not use this form. 
  • SASS CARES 24/7 Hotline: 1-800-345-9049 or please take your child to the nearest emergency room for any immediate needs or safety concerns.

If you have concerns about your child and would like to discuss services please fill out this form and we can figure out a plan together! If you have any questions at all, please do not hesitate to reach out to me.

Email: mckinneykm@winnebagoschools.org

Direct Phone Number: 815-335-3795

Thank you for your time! I will plan to be in contact with you within one week of your submission. :)

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Email *
What is your FIRST & LAST name? *
Today's date *
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What grade is your child in? *
I need to talk to Mrs. McKinney about: *
Please write a short description of your needs & Mrs. McKinney will respond to you as soon as she is able:) *
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