Request to See Mrs. Gabbert - Counselor for Last names I-Q

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Please fill out form to request to see your counselor. Please note that if you need to see a counselor IMMEDIATELY, and have not been called to the Counseling Suite by 3:30 pm today, please notify your teacher that you need to speak with someone today. Thank you!
* Required

Student Last Name *

Student First Name *

Grade Level *

Homeroom Teacher *

Request reason to see counselor *

Academic

Career

Social/Emotional

I have an issue or concern with: *

Academics/Grades

Academic Planning/High School Information

Anxiety/Stress

Bullying

Bus/Transportation Issue

Family

Friends/Peers

Grief/Loss

Scheduling/Classes (current)

Social Media/Cyber-Bullying

Other:

Please provide DETAILS of request for appointment or issue below *

Select the number below that represents how URGENT the situation is *

1-Not Urgent (Quick Question)

2-Within the next 2 days

3-Next available appointment time

4-IMMEDIATELY- You are in CRISIS or feel unsafe to be at school or home

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