I Need to See My School Counselor
2019-2020 School Year
I understand that I am not to use this form in the case of an emergency. If I am worried about my safety or the safety of others, I need to see the nearest adult to get help. *
What is your last name? *
Your answer
What is your first name? *
Your answer
Who is your homeroom teacher? *
Please select your school counselor *
I need to speak with my school counselor about... *
Your answer
Is there anything else you wish to tell your school counselor?
Your answer
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