Referral to Mrs. Izzi (Edgewood High School Counseling Office - Grades 9 and 10)
Please complete the following form to make a referral to Mrs. Izzi, grade 9 and 10 counselor.  Referrals can come from parents, teachers, or students themselves.  Complete the following questions and Mrs. Izzi will see you as soon as possible.
PLEASE NOTE:  Counselors do not maintain 24-hour access to email or referrals.  In the event of a counseling emergency:
Call National Suicide Prevention Lifeline: 1-800-273-TALK or 9-1-1.  

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Email Address *
Student's First Name *
Student's Last Name *
Student's ID number
Grade *
What is the reason for the referral? *
Required
Who are you referring today? *
Required
Name of Person Making Referral
How urgent is the issue? *
Not Urgent
Urgent
Briefly describe the issue, question, or concern, yet include as much detail as possible including student names as needed. *
Which periods do you (the student) have study hall/elective classes? *
Required
Submit
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