Parent/Guardian Request for Assistance Form

Hello Levi Dickey Parent/Guardian!

If you would like us to contact you or your student, please complete the questions on the form.
Please remember that if this is a medical / mental health emergency- please call 911 immediately.
We will be checking the responses on this form on a daily basis and you will receive a response as soon as possible.

Important Note: All educators are mandated and must immediately report any suspected child abuse or neglect to Child Protective Services.

Below are resources available should you find yourself or someone else in a situation where immediate mental health services are needed.

National Suicide Prevention Hotline --- 1.800.273.8255
Central Crisis & Suicide Prevention Hotline --- 1.888.506.5991
Crisis Text Line --- Text HOME to 741741

Please understand that confidentiality cannot be guaranteed in virtual meetings. CVUSD counselors will make every effort to ensure a confidential conversation, and as always, if there is a concern that someone may harm themselves or others, or that someone may be causing your child significant harm, the appropriate persons will be contacted.

Click HERE to access form.