School Counseling Office
The Elementary School Counselor
Stokes County Elementary School Counseling Programs Mission and Vision
Comprehensive School Counseling Program
Guidance Curriculum
Covid 19 Resources
Relax and Destress
Referral Forms
Student Self Referral Form
Staff Referral Form
Parent/Guardian Referral Form
Parent Links
Summer Enrichment Opportunities
Staff Referral Form
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Indicates required field
Student Name
*
First
Last
Please see this student
*
After Talking with Me
Urgent-ASAP
This Week
When you can schedule
Staff Email
*
Reason for Referral
*
Anger
Relationships with friends/peers
Feelings of negativity, discouragement, self-doubt
Study skills, grades and schoolwork
Recent changes in mood, attitude or behavior
Other (Describe Below)
Comment
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