Request to see a Counselor 2025-2026

Request edit access

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Please fill out this form to see one of your school counselors. We will schedule a time to meet with you. We do NOT check forms after school hours or over the weekend. If your need is urgent or you or someone you know is in crisis, please talk to another trusted adult, or call Maine's Statewide Crisis Line: (888) 568-1112 (call or text), National Suicide Prevention Lifeline: 1-800-273-8255, or Trevor Project LGBTQ Crisis Line: 1-866-488-7386 OR 911.

Email *

Record my email address with my response

Student Name (first and last) *

Person Referring if not the student

YYYY

Time

I have a concern about ... *

school

home

friends

other

Required

Level of Concern *

Low: I want to see you sometime this week

Medium: I want to see you today or tomorrow

High: I need you now (yourself or someone else is in danger)

Anything else we need to know?

Submit

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