Need to Talk? Virtual Break Room Appointment Request
This is not an emergency help line, and is only monitored between the hours of 9:00 a.m. and 2:00 p.m. If this is a mental health emergency, please reach out to one of these emergency lines:
California Youth Crisis Line 24/7 800-843-5200
Child Abuse Hotline for LA County 800-540-4000
Fire, police, ambulance, medical 911
Henry Mayo Behavioral Health 661-253-8989
LA County DMH 24/7 800-854-7771
National Domestic Violence 800-799-7233
National Domestic Violence-Spanish 800-942-6908
National Sexual Assault 800-656-4673
National Suicide Prevention 24/7 800-273-8255
Poison Control 800-942-5969
RAINN 24/7 800-656-4673
Rape, Abuse & Incest National Network
Strength United 24/7 818-886-0453/ 661-243-1722
(Experienced rape, sexual assault or child sexual abuse)
SAMHSA 24/7 800-662-4357
Substance Abuse & Mental Health Service Administration
SCV Sheriff 661-255-1121
Teen Line 6pm-10pm PST 800-852-8336
Trevor Lifeline 24/7 866-488-7386
(Suicide prevention to LGBTQ+)
Trevor Text text: START to 678678
First Name (Nombre)
Last Name (Apellido)
Student ID # (Identificación del Estudiante)
I think I would like to (Me gustaria):
Speak with The Break Room (Wellness Center) counselor
Speak with a school counselor
Speak with an assistant principal
Speak to Mr. R (Mr. Rounsaville) - School Social Worker
I'm not sure
When would you like to talk (Cuando te gustaria hablar)?
I would like to talk by the end of the day
If needed, I can wait until tomorrow to talk
Briefly describe how we can help (ex: peers/friends, grades, family, something else): Describa como podemos ayudar?
A copy of your responses will be emailed to the address you provided.
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This form was created inside of William S. Hart Union HSD.