Request edit access
WSD School-Based Counseling Referral Form
The Marathon County School-Based Counseling Consortium comprises of nonprofit and for-profit mental health clinics, public school districts, and community organizations. Consortium counseling agencies are able to provide on-site mental health counseling to students in all Marathon County public schools.
If you would like to refer your child for school-based counseling or would like more information, please complete the questions below and a representative from your child's school will contact you.  
Due to a community shortage of licensed therapists, several schools will have limited therapy appointments or none at all.  You will be notified if your child's school has been affected by the decrease in therapy and information to pursue community based counseling.   You may also contact your child's School Social Worker for more information. 

Sign in to Google to save your progress. Learn more
Date:                                       *
MM
/
DD
/
YYYY
Student Name *
School *
Parent/Guardian Name *
Parent/Guardian Contact Information - phone number and/or email *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Wausau School District. Report Abuse