MARION C. MOORE MENTAL HEALTH PRACTITIONERS
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Guardian Counseling Consent
Please read the Telehealth Consent Document, then give or deny consent.
Click this picture to view Telehealth Consent Document
Telehealth Consent Form
*
Indicates required field
Student Name
*
First
Last
Guardian Name
*
First
Last
Grade
*
6th
7th
8th
9th
10th
11th
12th
Consent for Telehealth Counseling Services
*
I Give Consent
I Deny Consent
I understand and have read the Telehealth Counseling Guidelines above
Best way to contact student (ie 555-555-5555 after 11am or
[email protected]
...etc)
*
This could be calls, text, email
Submit
Parent & Staff Health Resources
Click picture for indicated resource! Stay healthy Guys!
Tips For Handling School Breaks
Self-Care Ideas
Successfully Supporting Students
Teacher Well-being
Stress Exploration
Financial Assistance, Local Food Assistance..etc
Staff Tips for Successful Online Learning
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Student Resources
Parent & Staff Resources
Mrs. O's Corner
Contact Us & Referral Link