SOAR Distance Counseling Check-in
This form is for NON-EMERGENCIES only. If you are experiencing a medical or psychological emergency, contact 911 or the appropriate agency:

National Suicide Prevention Lifeline 1-800-273-8255 (24 hours)
Department of Child & Family Services - Child Abuse Hotline 1-800-540-4000 (24 hours)
Antelope Valley Domestic Violence Council 661-945-6736 (24 hours)
LA County Health & Human Services - dial 211 (24 hours)
Last Name *
First Name *
Are you a ... *
Grade Level *
Contact Email *
Contact Phone Number *
Your primary area of concern is... *
Reason for Visit (check all that apply) *
Required
Who do you need to talk to? *
How do you want to be contacted? *
Submit
Never submit passwords through Google Forms.
This form was created inside of Antelope Valley Union High School District. Report Abuse