Permission Slip

Dear Parent(s) / Guardian (s):

As we discussed by telephone, I would like your permission to provide school counseling support to your child to address the following issues and concerns that impact your child at school:

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Counseling services may include up to six (6) one to one and / or group sessions generally provided during the lunch period so as not to interrupt academics.  In addition, a follow-up call will be provided to keep you informed of their progress.  Please feel free to call me at any time with your
questions or concerns.

Sincerely,
Ms. Angie Charlton
Mrs. Ruth Ghobadi
Guidance Counselors
(703) 262 – 2700

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I give permission for my child, ____________________________________ to receive either one-to-one and / or group counseling services from
Ms. Angie Charlton and / or Mrs. Ruth Ghobadi.

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