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Text Box: School Counseling 101-A

School

Counseling 101-B
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Text Box: Patients Bill of Rights

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Text Box: PERMISSION SLIP SCHOOL COUNSELING SERVICES Dear Parent / Guardian, COMPLETE & PRINT FORM HERE Your child, ___________________________________, has been referred to the school-counseling program. The counseling program takes place during regular school hours. Your child would be seen in a group or in an individual session each week and participate in a number of activities related to counseling. In order for counseling services to be provided, your permission is needed. If you agree to allow your child to participate in the counseling program at the school please print and sign your name below. Return this form to the school with your child as soon as possible, as there are only a certain number of children who can be served each week. I, ________________________________ (parent/guardian printed name) agree to allow my child _______________________________________(child’s full name), ____/______/______ (date of birth) to participate in weekly counseling sessions for the current academic school year. Signed: ______________________________________ Date: ______________________________________ Address: ______________________________________ ______________________________________ Phone: ______________________________________ Should you need to speak to the counselor, you may contact the school and leave a message asking for a return phone call. The counselor who will be working with your child (provided you give your permission) can be reached by contacting: Kurt LaRose, MSW OFFICE LOCATION: PO BOX 180671 220 John Knox Road Tallahassee, FL 32318 Tallahassee, FL 32303 Email: klroze@nettally.com (850) 545-2886 “Permission Slip School Counseling Services” © Copyright 2005 - 2009, Kurt LaRose, Tallahassee, FL 32303. Permission to reproduce and distribute is granted to all school personnel where Kurt LaRose is rendering contracted counseling services. Other use prohibited without written permission. COMPLETE & PRINT FORM HERE

WHY SHOULD I SEND MY CHILD TO A MENTAL HEALTH COUNSELOR AT SCHOOL?

Website layout, text & design Copyright © 2005-2009 - Kurt LaRose

WHAT ARE SCHOOL COUNSELING SERVICES?

DATA ANALYSIS: DOES THE SCHOOL COUNSELING PROGRAM WORK?

ORDER INSERVICE PRESENTATION ON SETTING UP SCHOOL COUNSELING PROGRAMS

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