Professional School Counselor Referral Process Guide Page 24
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28Missouri Comprehensive Guidance and Counseling Programs: Responsive Services Component
Referral Process Module
Page 24 of 28
RESPONSIVE SERVICES: REFERRAL PROCESS
Outside Referral Contact Form Cover Letter
(School Letter Head)
Date
Dear Provider,
I am the Professional School Counselor at (school name). I am compiling a file of contacts,
agencies and other resources I can use with my students, parents and families. I would like to
include information about your services for children and families. Will you please complete and
return the enclosed form? I would appreciate your including brochures or helpful handouts
about your services with the form. I plan to make completed forms and informational materials
available to parents/guardians, teachers and students.
Your contribution will add to the
resources I provide for families, staff and students at my school.
Thank you ahead of time for your time and assistance!
Students will benefit from your
investment!
Educationally,
(Name of Professional School Counselor)
(Name of School)
(School Address)
(Contact phone/e-mail)
Missouri Comprehensive Guidance & Counseling Programs:
Linking School Success to Life Success
To ensure that the work of educators participating in this project will be available for the use of schools, the Department of Elementary
and Secondary Education grants permission for the use of this material for non-commercial purposes only.
May 2015
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