Referral to School Psychologist / School Counsellor

Note for parent/ carer: Use this form to provide information about your concerns for your child.

Upon receipt, your referral form will be triaged by the school psychologist / school counsellor.

The school psychologist / school counsellor will contact you to discuss the outcome of the triage process and will ask for your consent before taking any action.

PRIVACY NOTICE: This information is being obtained to assist the school psychologist / school counsellor in providing support for your child. It may, as appropriate, be provided to other members of the school staff involved in supporting your child. Provision of this information is voluntary. The information you provide will be stored securely. You may correct any personal information provided at any time by contacting the school counsellor.

Parent/ Carer Referral to School Psychologist/ School Counsellor 2026

Yarrawarrah Public School