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Counseling Referral Form
Please use this form to refer students who have academic, personal/social or career concerns to the middle school counselor, Krista Wells.
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Name of Person Making the Referral
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Relationship to Student Being Referred
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Contact Information?
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Student Name (s)
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Student Grade Level
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Please give a short description of why you think this student (or these students) need to see the counselor.
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