SLHS Counseling Request Form 2016-2017
Use the form below to make an appointment to see your counselor.  If this is a crisis, DO NOT use this form.  Contact a counselor, administrator or school employee immediately. Main (510) 618-4600 ext 2164 FTK (510) 618-4600 ext 2322
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Email *
Who is your counselor? *
Who do you need to see?
What is your first name? *
What is your last name? *
What is your permanent student number?
What is your grade level? *
Reason you want to meet with your counselor? *
Optional:  Provide a brief explanation why you want to meet with your counselor.
Preferred Period/s to meet with counselor *
Email Address
Contact phone number
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