Bears Care Crisis Support Form
At Gray's Creek, we want you to know that you are not alone! This form has been created for students in crisis, meaning there is a serious issue or concern that needs to be addressed. If at all possible, students should reach out to parents or guardians first; however, we at Gray's Creek will assist students at any stage of a crisis within legal and responsible parameters.
* In most situations, we will eventually or immediately have to inform other qualified adults about sensitive information or circumstances. This is only to provide the best support and protection for you and all involved. Items with the * beside them are mandatory. The others can be skipped, but we prefer that they are answered when necessary.
Contact information (this can be phone number, social media platform name, etc.)
Nature of Crisis
Extreme Anxiety or Depression (outside of what is normal for you)
Someone you know is going through one of the above
You are in immediate danger/harm
How soon do you need assistance?
Within 12-24 hours
Within the time span of a week
If you can, please give us more details about your selected "Nature of Crisis".
Please provide your location if possible, any details that can help someone find you if necessary.
Is there anyone we can contact for you to get more helpful information? A person we can help you locate? Please provide the person's first and last name and number (even if they are not picking up the phone at this time).
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This form was created inside of Cumberland County Schools.