Mental Health Opt-In Form

All students must have a Mental Health Opt-In form on file for me to provide counseling services, lessons, and activities. Without it, I cannot meet with students or lead classroom lessons. Please see below for a better breakdown of the mental health opt-in options.

📝 Mental Health Opt-In Breakdown

📊 Surveys & Assessments

• Short surveys/check-ins on stress, emotions, coping skills, or goals
• Helps me understand student needs and growth
• All surveys and assessments are strictly confidential
• Students cannot participate if this option if it is not selected on the form.

🆘 Crisis Intervention

• Immediate, short-term support during a crisis (panic attack, anxiety, overwhelmed, etc.)
• Without this option selected, I cannot step in unless it’s a safety emergency or loss of an immediate family member

💬 School-Based Mental Health Services

• Small group counseling (friendship, coping skills, etc.), facilitated by the school counselor
• One-on-one check-ins by the school counselor when needed
• Classroom lessons that build social-emotional skills, also facilitated by the school counselor
• Referrals available for long-term therapy (parents must approve and be involved in the process for children under 16)
• If this option is not selected, students cannot participate in small group counseling, one-on-one check-ins, or classroom lessons.

📌 Reminder: Parents may choose 1, 2, or all 3 options, or may also choose to not select any options. I can only assist students in the areas you select.

In Accordance with Alabama law, even if you do not opt-in to mental health services, your child may be provided mental health services by a counselor due to:

1. An imminent threat to the health of the student or others;

2. Suspected abuse, neglect, or exploitation; or

3. When there is an immediate necessity for immediate grief counseling.

You can download a copy here: