







Parental Consent for School Health-Related Services
Per Senate Bill 12, Texas school districts must have written parent/guardian consent before providing any non-emergency health-related services at school or during school-sponsored activities. Only lifesaving care may be given without consent.
Health-related services may include:
Services may be provided by nurses or trained school staff (e.g., teachers, coaches, counselors). If you decline consent on this form, your child will not receive care for non-life-threatening issues and must be picked up immediately if ill or injured.
In accordance with Senate Bill 12, Southside ISD must notify parents of available school counseling services and allow them to opt out before services are provided. Consent through this form applies for the 2025–2026 school year unless rescinded by the parent/guardian.
School counseling services include academic advising, early mental health prevention, emotional and social skill-building, grief and trauma support, positive behavior and youth development, and promoting a safe, supportive school climate. These services are outlined in board policies FFEA, FFEB, and FFB.
This form seeks consent for general mental health–related services only. Separate consent will always be obtained for small group or individual counseling.