"My Student Needs to See Ms. Doyle" Request Form
DIRECTIONS:  THIS FORM IS FOR NON-EMERGENCIES ONLY.  If this is an emergency and you need help right away, please dial 911.

All other requests, Ms. Doyle, Wood Elem. School Counselor for Grades 2 through 5, will be scheduled as soon as Ms. Doyle's schedule allows.  Your request for help is confidential (is only seen and received by Ms. Doyle).
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Student's First Name: *
Student's Last Name: *
What grade is the student in? *
Who is the student's teacher? *
Your Name (& number, if you are not a school employee) *
What is your relationship to the student? *
What is your concern? *
Required
I give permission for Ms. Doyle, the School Counselor, to fulfill my parent/teacher request.  (The student's privacy is important to me.  I will contact an adult to make sure that I am scheduling the meeting at a time that is best.  In our counseling sessions, Ms. Doyle has to practice confidentiality, meaning anything that the student says in session stays in the session. There are three exceptions to make sure the student remains safe. Those exceptions are: 1) Someone is hurting him/her. 2)  He/She wants to hurt someone. 3) He/She wants to hurt themselves. ) * *
Please list any additional concerns that you may have, that are relevant to your request.
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