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Counselor Request Form
Use this form to request a visit with your school counselor! :)

Be...
STRONG enough to stand alone,
SMART enough to know when you need help and,
BRAVE enough to ask for it.

First name: Test *
Your answer
Last name: Test 2 *
Your answer
Grade *
Teacher's name *
Your answer
Reason I need to see a counselor *
I would like to see you...
Submit
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