Request to see the counselor
Name (first & last) *
Your answer
Date
MM
/
DD
/
YYYY
Grade
Who is your counselor?
I need help with: *
When would you prefer to be seen
Please give a brief description of the situation:
Your answer
Disclaimer: Please be aware that this form sends an electronic notification to your counselor and may not be seen immediately due to counselors visiting with other students, participating in meetings or being out of the office. If this is a situation that needs to be addressed immediately please contact the main office directly in person or by calling 636-668-8130. In the event of an emergency please dial 911. Any other requests will be prioritized based on need. *
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