School Counselor Referral Form Kit: Self-Referral, Passes & Logs

This school counselor referral form kit covers staff and parent referrals, student self-referrals, counselor passes, session notes and caseload tracking in one simple system.

What's included (7-page PDF plus individual pages):

• Staff & Parent Referral: 15 checkbox reasons, what's been noticed, what's been tried, urgency, safety reminder, counselor-use-only box
• - Student Self-Referral (2 per page): feelings check-in, topics, "how soon?", comment box
• - Counselor Pass (3 per page): time out/back, come now or at a set time, returned-to-class check
• - Session Notes: contact type, focus areas, what the student shared, what you worked on, goal, follow-up
• - Referral & Caseload Log: 25 rows from date received to first seen to closed, with reason codes
• - Parent & Staff Contact Log: 18 rows for calls, emails and meetings
• - Welcome page with printing tips and terms of use

Who it's for: school counselors from upper elementary through high school.

Format: instant download PDF, US Letter, not editable. Confidential pages are marked; follow your district's records and reporting policies. These forms support, not replace, crisis and mandated-reporting procedures.

Try it free first: FREE Counselor Passes & Self-Referral Slips https://payhip.com/b/kpU2F | Save with the School Staff Bundle ($14): https://payhip.com/b/OJDdw