Request for School Counseling Appointment '25-'26

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Please complete this form to request an appointment with your School Counselor. If you are sending this request outside of school hours, we will get back to you during school hours. ** If you need immediate help, please go to the Main Office. **

Email *

First and Last Name *

What grade are you in? *

5th grade - Mrs. Keane

6th grade - Mrs. Gitomer

7th grade - Mrs. Keane

8th grade - Mrs. Gitomer

I would like to see my School Counselor *

as soon as possible.

within the next couple of days. This is not an immediate need.

What would you like to discuss? *

School concerns

Family concerns

Social concerns/ concerns regarding classmates and/or friends

I'd like to discuss something besides what is listed here.

Other:

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