Talk Time - Harmony Public Schools

Talk Time Request Form

During Talk Time a parent/guardian should be at home, we will need the contact number for the person that will be at home during this time. This Talk Time will occur via a Zoom meeting. Students will need internet connection and should have a quiet and private area. Please note that due to demand it may take a counselor 1 business day to respond to this form. This forum is not set up for emergency situations, if you have a medical or mental health emergency please call 911. Permission for Talk Time can only be granted by a parent/guardian. If you have an urgent mental health need related to the stress of COVID-19, please call the COVID-19 hotline at 833-986-1919.

If your child attends school in HOUSTON NORTH District, please visit their campus website and look for the SAF (Student Assistance Form) link or QR code.

Your Consent (required)

I have read the expectations detailed above and agree to the terms.

Yes

No - you must accept terms for counseling to occur

I understand that by completing this form I am giving consent for my child to receive virtual Talk Time services. Following this submission I will be contacted by telephone to verify this consent before Talk Time will occur. Please print full name,**

Please select the campus **

Parent/Guardian Information

Name **

Phone Number**

Parent Email (optional)

About Student

Student Name **

Grade (optional)

Best time frame to contact to schedule Talk Time?

Does student currently see a counselor at your campus?

Yes

Is the student currently attending school online or in person?

Yes

Do you need translation services?

Yes

What are your child's Talk Time needs? If this is a medical emergency please call 911 or if you need to speak to someone immediately please call the COVID-19 mental health hotline toll free at 833-986-1919.

Talk Time Request Form

Your Consent (required)

Parent/Guardian Information

About Student

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