Parent/Guardian Referral Form
Our aim at Prairie Vale Elementary is to help foster development not only within the realm of academics for your child, but also social and emotional development as well. Individual and small group sessions are offered to address student concerns in the personal, social, and academic domains. The purpose of groups and individual counseling is to provide education and support.
Potential areas in which children might need assistance:
Counseling is based on a trusting relationship between counselor and student, therefore the counselor will keep information shared by the student and/or parent confidential except in certain situations in which an ethical responsibility limits confidentiality. By law and ethical standards confidentiality must be broken if:
1. The student reveals information about hurting himself/herself or another person.
2. The student reveals information about abuse or neglect.
3. If records are subpoenaed in a court of law.
If you would like to refer your child for these services, please fill out the confidential referral form below.
Potential areas in which children might need assistance:
- Anxiety
- Sadness
- Difficulty getting along with others
- Coping with family changes
- Grief and Loss
- Social Skills
- Friendship Skills
- Self-Control
- Anger Management
- New Student Transitions
- Other! Anything you might see as a concern area
Counseling is based on a trusting relationship between counselor and student, therefore the counselor will keep information shared by the student and/or parent confidential except in certain situations in which an ethical responsibility limits confidentiality. By law and ethical standards confidentiality must be broken if:
1. The student reveals information about hurting himself/herself or another person.
2. The student reveals information about abuse or neglect.
3. If records are subpoenaed in a court of law.
If you would like to refer your child for these services, please fill out the confidential referral form below.