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ECG Counselling Request
Please ensure all compulsory sections of the form are completed before submitting. We will contact you shortly to arrange for an ECG counselling session. All ECG counselling sessions will be arranged during recess times or between 2.25pm - 3.00pm on Wednesdays. For ECG counselling sessions after 3pm on Wednesdays, please obtain permission from your respective CCA teacher-in-charge, if you have to attend CCA on Wednesdays.
Email address *
Name of Student(s) *
Your answer
Class *
Email address *
Your answer
Contact Number *
Your answer
Choose ONE slot: Venue@ We Breathe Room (Next appointment: 28 Mar 2018) *
Brief Description of Issue/Concern *
Your answer
Type of Referral *
Name and Designation of Teacher (if referral is made by staff)
Your answer
Have you consulted any teachers or counselors before this? *
Name of the teacher/counselor you have consulted before
Your answer
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