Talk to My Counselor: Mrs. Clark

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Talk to My Counselor: Mrs. Clark

Please fill out this form and I will make an appointment to see you. Please provide as much information as you can. This information helps me be prepared to help you. If this is an emergency, please speak with a trusted adult immediately, or text/call 988 in the case of a mental health crisis. An emergency constitutes as harm to self or harm to others.

Requests are checked daily between the hours of 8:30-3:20 when school is in session.

FYI: Requests submitted after school, weekends, or during breaks will not be seen until the next school day. As a reminder, it could take more than one school day to receive a response from my counselor, but she will see me/reach out to me as quickly as she can.

Email *

Record my email address with my response

Name: *

Please Select One of the Following:

I am a...

Student

Teacher/Staff

Parent

I want to talk about... *

Academic Concern (Grades, Missing Work, Scores)

Mental Health Concern for Self/Others (self harm, suicidal ideation, depression)

Problems in School (Problems with a Peer, Problems in a Class/Team)

Problems at Home

Ask a Question

Other:

Required

Please provide more information about the reason(s) you selected above. If you just have a question, please type it here.
*

I understand that if this request is related to harm to self or others, I need to report it a trusted adult right away.
*

Yes, I understand.

I understand that it could take more than one school day to receive a response from my counselor, but she will see me/reach out to me as quickly as she can.
*

Yes, I understand.

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