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Request a Meeting with the K–8 School Counselors  

Thank you for reaching out to the Franklin Academy Counseling Department.

We are here to support our students' academic, social, emotional, and behavioral well-being. If you would like to meet with one of our school counselors, please complete the form below. We will contact you within 1–2 school days to schedule a meeting at a mutually convenient time.

If this is an emergency or your child is experiencing a mental health crisis, please contact the school office immediately or call 911.

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Email *

Parent/Guardian Information 

Name

*
Student's Full Name
Student's Grade
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 Contact Information,  Phone Number 
 Email Address    

Meeting Information

Which counselor would you like to meet with? Jessica Fernandez Ms. Clermont Either Counselor
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  What is the reason for your meeting?  
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  Please briefly describe your concern  
  Preferred meeting format:  
  Preferred Day(s) , Checkboxes
  Preferred time  
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  Is this request urgent?  
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Submit
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