• Referrals

  • Student's Self Referral

    Hello Bearcats! Please, feel free to fill the form to see us! This form is an auto-referral form. 

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  • Teacher's referral form

    Hello teacher! Here is the referral form for students to the At-risk team. 

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  • Parent's referral form

    Hello and thank you for your interest in virtual sessions with your school counselor. When parents request a series of counseling sessions we request informed consent by the parent, which in this form. Because virtual sessions are unique, we ask parents to be present as well. I am including the ethical standards provided by the American School Counselor Association below. 

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  • Counseling Referral Process


    Ways to refer.

    • A child may refer themselves.
    • A teacher may refer a student.
    • A parent may refer his/her child.
    • A staff person on campus can refer a student.
    • A physician may refer a student.

      For a parent/ counselor meeting.
    • Call the school counselor to set up an appointment
    • Send a note or an email to the counselor requesting contact

    Reasons for a referral.

    • You have concerns with your child's attitude toward school.
    • You have concerns with your child's academic growth.
    • You have concerns with your child's relationships with peers at school.
    • You have concerns with your child's personal development.
    • You have concerns with your child's reactions to changes within the family that may be effecting his/her learning at school.

     
    Why should it be done:

    • Provides students with more one on one help, support, and intervention
    • Increases specificity of interventions and supports and tailors them to the student
    • Increases privacy for the student
    • Removes the student from the situation or circumstance to discuss solutions to it
    • Reduces anxiety and pressure on student
    • Provides the student with the full attention of an adult
    • Makes student feel secure
    • Allows an adult to give a student undivided attention
    • Frees the teacher up to continue teaching the rest of the class without having to stop to speak or counsel a student in the hall or away from the class

    When should it be done:

    • When students are over emotional and cannot calm down in an appropriate and brief amount of time
    • When a student’s needs are greater than those the teacher can provide in the classroom setting
    • When a student requires more support and attention to address or solve a problem, issues, etc
    • When students need more specific and individualized help, solutions, and plans to address issues
    • When a student needs more privacy than a teacher can provide in the classroom

    How should it be done:

    • Counselor referrals may be planned or spontaneous
    • For planned referrals, have the student set up a day or days and times to meet with the counselor ahead of time and provide the student with reminders
    • For spontaneous referrals where an incident happens and the student unexpectedly requires counselor support, send the student down to the counselor with a note briefly explaining what happened, or send the student down and call and explain to the counselor the issue.
      • You may walk the student down or send another student to walk down with the student to the counselor
      • The counselor may also come to the room to retrieve the student
    • Be vigilant of students abusing counselor referrals as a means to avoid work or something else
      • If you suspect students are abusing the intervention, use the student's agenda where they have to check off each time they see the counselor, limiting them to a certain number of visits per period, for example, 3 visits a week or 1 visit a day, etc.