• 2018-2019 Teacher/Staff Counseling Referral Form

    Once you've complete and send the form an email will be sent directly to Ms. Dominguez, Ms.Chavez, and Mr.Hernandez notifying them. The student will be added to their list of students to see. **If the presenting problem is dealing with some type of harm that qualifies as an emergency (the student being harmed by someone, the student is planning to harm someone else, or the student is self harming) secure the student then please contact the office via phone AND complete this form.If the student is being abused in any way please contact CPS immediately, you have 48 hours to report suspected or possible abuse.**
  • 2018-2019 Teacher/Staff Counseling Referral Form




  • Should be Empty: