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Grade
*
8th Grade
9th Grade
Required
First Name
*
Your answer
Last Name
*
Your answer
I want to meet with:
*
Mr. Pollock (A-J)
Mrs. Wadsworth (K-Z)
Any Counselor
Other:
Reason:
*
Emergency/See ASAP
Personal
Academic advisement (Schedule changes etc.)
College/Scholarships
Social Conflict/Safety/Bullying
Interventions
Recognition (Shield Club, etc...)
Any additional info or comments (CONFIDENTIAL)
Your answer
If it's an EMERGENCY...
24 hour hotline available for emergencies SAFE UT app (in google play or app store) or call 1-800-273-TALK (8255)
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