Self-Referral Forms For School Social Workers And School Counselors
- Grades
- Not Grade Specific
- Pages
- 6
- File type
- Preparation
- Print ready
- Subject
- Resources for Teachers, Social Skills
- Topic
- Self-referral forms, School counseling
- Preparation
- Print ready
Product description
From the author
Give students a written way to request a conversation with the school counselor or social worker. This six-page PDF includes a cover, instructor note, two pages of self-referral slips and two pages of matching hall passes.
Each referral slip asks for the date, student name, teacher, conversation topic and size of the concern. Print copies for classrooms and explain how students should submit them. The instructor note suggests using passes with students who find it difficult to say when they need a break.
Referral topics can inform follow-up conversations and planning for a classroom curriculum. These are request forms and passes; appointment times and staff follow-up are arranged through the school’s own routine.
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In the classroom
Teaching tips & learning objectives
Teaching tips
Give teachers stacks of the referral slips to keep on hand in their own classrooms through the year
Reserve the hall passes for students who tend to keep concerns to themselves or find it hard to say out loud that they need to talk
Photocopy each page before cutting it apart, since a single page holds two identical referral slips or six identical hall passes
Good to know
Questions teachers ask about this resource
What does a student fill in before handing in a chat slip?
Their name, the date and their teacher, plus a topic selection and a rating for the size of the problem.
Can I use these with both a counselor and a social worker?
Yes. The PDF includes referral slips and matching hall passes labeled for each role, so you can choose the versions used by your school.
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