Request edit access
Student Request to See Counselor
I am having an issue, and I need to talk with the counselor
I would like to see my counselor because...check as many as you need.
I am worried about school
I am worried about a friend/other student
I am worried about home
I am having trouble with another student
I am having trouble with an adult
I am trying to do better, but it is hard
I can't concentrate
I am hurting myself or want to hurt myself
Someone else is hurting me
Tell me a little bit about your problem
I need to see you
Right away! = BIG problem
Sometime this week
Never submit passwords through Google Forms.
This form was created inside of Lakeland School Corporation.
Terms of Service