Counseling Referral

Please use this form for referrals to the school counselor. You may also email this information. In the case of an emergency please call 911. If there are immediate non-emergency concerns of risk/crisis for the student or another family member, please ensure to first follow all mandated reporter laws and then contact Sr. Josephine directly at cell phone number 903-202-0760.

Thank you,
Sister Josephine 

 

Counseling Referral Form

Student information
Is the student self referring?
Please provide a brief reason for referral
This can be brief and not too much detail - I will follow up in person for additional details. If the student is self-referring and did not disclose a reason then leave blank. Thank you!
For staff only
If the student is not self-referring, and you are recommending the student for counseling, have you mentioned this referral to the parent(s)/guardians?
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