School Counseling Service Request Form
Dear Students,

Please complete the School Counseling Services Request form below if you need to see a counselor. We will do our best to see you within a reasonable amount of time. Please only submit one request per day. Submit form and wait for a counselor to follow-up with you. Please do not come by the office to check or fill out another request until a counselor sees you.


Thank you,

The LHS Counseling Team
Email address *
Student (Last Name, First Name) *
Your answer
Counselor Requested *
I need to see the counselor about: *
Please provide more details about your request below
Your answer
Please rate the level of urgency: *
Can wait
Must be seen immediately, emergency situation
A copy of your responses will be emailed to the address you provided.
Submit
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