Parent/Guardian Request for Student Support

Dorchester County Public Schools is committed to supporting the academic, social, emotional, behavioral, attendance, and overall well-being of every student.

Please complete this brief form if you would like assistance or would like to connect your student with school or community supports. Your request will be reviewed and shared with the appropriate school or Student Services staff member for follow-up.

IMPORTANT: This form is not monitored continuously and should not be used for emergencies or immediate safety concerns. If there is an immediate threat to the safety of your student or another person, please call 911.

Parent/Guardian Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

What is the best time to reach you?

Student's Name

First NameLast Name

School

Student's Grade

What type of support are you requesting? Please select all that apply

Please briefly tell us how we can help. Please share any information that may help us better understand your concern or the support your student may need.

Are there any family or household needs that may be impacting your student's well-being, attendance or success at school? Please select all that apply.

Please share a positive quality or strength about your student and family...

Important:
Responses are monitored and reviewed during school hours on regular school calendar days (Monday-Friday) only. If your student is experiencing a mental health crisis after school hours please call 911 or go to the nearest hospital or call/text 988 Suicide & Crisis Hotline

If this is an emergency and your student or a child you know is in immediate danger to themselves or others please immediately call 911 or take the child to the emergency room immediately.

If you are worried about the safety or possible abuse of a child, please contact our local Department of Social Services at 410-901-4100