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I Need to See My Counselor
* Indicates required question
Email
*
Record my email address with my response
Today's Date
*
Your answer
FIRST AND LAST NAME
*
Your answer
GRADE
*
6TH
7TH
8TH
Who is your counselor?
*
Mrs. Guerrero (A-L) Counselor
Mrs. Salgado (M-Z) Counselor
How do you feel today?
*
Your answer
What do you need to talk about ?
*
A Friend
School
Family/Home
Something Else
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Tell me more about your problem?
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Your answer
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