Request To Chat with Ms. Tara Monzet Wellness Center Counselor

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Thank you for reaching out! I look forward to helping you connect to resources and support.

Please complete the following information if you would like assistance from the Wellness & Guidance Center. If this is an emergency, please contact 911 immediately.

If you or someone you know someone needs immediate help, please call or text the National Suicide Prevention Lifeline at 988.

Caver Wellness & Guidance Center Hours:
Monday through Friday (during the school year)
7:30am through 4:00pm

Please note self-referrals are monitored Monday through Friday during the academic year and I will follow-up as soon as possible.

Email *

First and Last Name of Student *

Student ID Number *

Are you concerned for someone else?

If so are you Is student aware of the referral *

Yes

N/A

Grade Level *

Best phone number to reach you if necessary (XXX) XXX-XXXX

Strengths and Interests (things you like or that make you happy)
*

On a scale of 1-5, how you are feeling ? *

Struggling, I'm Feeling Awful

Amazing, I'm feeling Great

I would like to discuss *

Group Counseling

Individual Counseling

Coping Skills/ Mindfulness

Bring Change to Mind Club ( Wellness Club)

Other:

Current Concerns: 

Safety Concerns (Please get immediate assistance--Call 911 or National Suicide Prevention Lifeline at 988

Depression

Anxiety

Social Withdrawal

Alcohol/Drug Use

No or Limited Motivation

Attendance

Bullying

Irritability

Other:

Required

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