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Consent for Individual Counseling

About this Form

Form number: 339-1

Audience:  Parents/Guardians

Last revised: May 2020

The school counselor, psychologist, or social worker can provide regularly-scheduled or an ongoing series of individual counseling sessions to students with permission from the parent(s) or guardian(s). These counseling sessions are designed to teach skills to help students be more successful in their academic and social environment. Many students may improve their school performance, attendance, and attitude towards school by taking part in individual counseling sessions. Self-help issues developed in these counseling sessions often include coping strategies, stress management, problem solving, and social skills. These sessions are not intended to replace non-school based counseling that you may arrange for the student. Please note that this consent is not necessary for every visit or drop in that a student makes to a school counselor, psychologist, or social worker; consent is only required for regularly-scheduled or an ongoing series of individual counseling sessions. This does
not include visits exclusively regarding course scheduling or college and career planning.

For group counseling, see MCPS Form 339-2, Consent for Group Counseling

Adobe PDF Consent for Individual Counseling457 KEnglish
Adobe PDF Consentimiento para Consejería Individual490 KSpanish
Adobe PDF Formulaire d'autorisation pour séances de thérapie individuelle477 KFrench
Adobe PDF Ưng Thuận cho Cố Vấn Cá Nhân551 KVietnamese
Adobe PDF 個別輔導同意書637 KChinese
Adobe PDF 개별 카운슬링 동의서(Consent for Individual Counseling)506 KKorean
Adobe PDF ስለ ግለሰብ የምክር አገልግሎት የስምምነት መግለጫ506 KAmharic

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