Counselor Request
Please fill out this form to see a school counselor! Thank you!
* Required
First Name
*
Your answer
Last Name
*
Your answer
Grade
*
6th
7th
8th
Please click all that apply
*
I am being bullied;
I feel unsafe;
I need to fill out a Blue sheet
Friendship/Relationship questions or concerns;
I want to talk about my schedule;
I need school supplies;
I have an issue with an adult
I need clothes(tshirt/shorts/pants/underwear/socks/shoes/etc);
Requesting a weekend food bag
I missed breakfast/lunch( I need a snack);
Required
When convenient- Not Urgent (Schedule Questions/Friendship/relationship concerns/school supplies, food or clothes)
Right Away - Emergency
Clear selection
Please state your reason why you'd like to talk to a Counselor if it is NOT listed above, thank you!
Your answer
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