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Mary FayPendleton School

Counselor's Corner » Parent Referral Form

Parent Referral Form

Individual counseling

Students will meet with the counselor one on one to discuss a variety of issues.  This will take place in a safe, confidential, and positive setting. The topics discussed with be based on the needs of each individual student.  These services will be provided by appointment, referral, and in crisis situations. The topics could include: grief and loss, problem solving, feelings, stress, academics, bullying, social skills, self-esteem, and getting along with others.

Please fill out the below form and return to the front office or email to