The Next Form

This our decision form for student ministry. Please let us know about your conversation in as best detail as you know possible. Remember, accurate data is key for follow up. 

 

Please complete the form below

Counselor Name *
Counselor Name
Student's Name *
Student's Name
Phone
Phone
Decision *
Please remember if this student is being harmed, potentially being harmed, or is considering harming themselves, to request a staff member to help before allowing that student to leave.