Counselor Request Form
Complete this form to refer yourself for counseling intervention and support. We will only be able to see your requests Monday through Friday during the school day. 

After you submit this form, a counselor will call you down to meet with you.  It may not be immediate so please be patient.  

****Counselor Requests are NOT for emergencies****

If you or someone you know is unsafe or when serious risk of harm in involved, you need to TELL AN ADULT IMMEDIATELY or call 911.  

Sign in to Google to save your progress. Learn more
Student's Last Name *
Student's First Name *
Student ID *
Grade *
What is your concern? *
Required
Who is completing this form? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Denton ISD.

Does this form look suspicious? Report

Google Forms