Description
Turn “something feels off” into clear, objective documentation a school counselor can act on.
This 7-page fillable PDF toolkit helps teachers and student-support teams notice warning signs, document observable patterns, choose the appropriate next step, submit a useful counselor referral, and follow up after the referral.
What’s included
- Warning Signs Checklist: Academic, behavioral/emotional, and attendance concerns organized by support level.
- From Judgment to Observation: Replace vague impressions with specific, objective language.
- Observation Log: Track patterns over time instead of relying on memory.
- Support, Refer, or Emergency? Decision Guide: Choose the appropriate response.
- Student Concern & Referral Form: Fillable student information, concern categories, urgency scale, and documentation prompts.
- Follow-Up & Communication Log: Close the loop and monitor changes.
Perfect for
- Middle and high school teachers
- School counselors and student-support teams
- Grades 6–12
- MTSS, RTI, Tier 1, and early-intervention documentation
- Teacher-to-counselor referrals
- Staff professional learning
Product details
- 7-page digital PDF
- 77 genuine fillable fields
- Type directly into the forms or print and write
- US Letter size
- Instant digital download; no physical product will be mailed
Created by a former high school counselor with 15 years of experience supporting students.
Important: This resource is educational and organizational. It does not provide legal, clinical, or medical advice and does not replace mandated-reporter training, district policy, crisis procedures, or emergency protocols.
Related guidance: See how Guidance Game Plan develops practical school resources.
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