School Counseling Appointment Request

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Please complete this form to request an appointment with your counselor. Please allow 24 hours for a response (excluding weekends and school holidays).

If you are experiencing a mental health emergency/crisis get help immediately. Text or call 988 for the National Suicide Help Line. If you are at school in crisis ask a teacher to walk you to the counseling office, clinic or main office.

Students: Your counselor will send you an email listing your appointment day and time.

Parents: Please note your appointment preferences and the secretary or counselor will reach out to you.

Note: Our conversations will stay between you and your counselor, unless one of the following occurs: someone is hurting you, you are hurting someone else or you want to hurt yourself. These concerns need to be reported to keep you and others safe.

Which counselor do you need a meeting with? *

Ms. Edlow (grades 3-5)

Ms. Youell (grades 6-8)

I need to discuss: *

Academics (ex. grades, schedule, teacher)

College / Career Readiness (ex. Xello, academies, college)

Personal (ex. home, friends, listening ear)

Other:

What should we know before we meet? Please briefly describe the issue. *

Person requesting the meeting. *

Student

Parent / Guardian

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This form was created inside of Hampton City Schools.