19-20 Student Counseling Request Form
**FOR EMERGENCIES COME STRAIGHT TO OUR OFFICES**
Once you complete and send the form an email will be sent to Mrs. Julian & Mrs. Duncan. They will add you to their list of students to see. Thank you!
First and Last Name
Your Student ID #
What grade are you in?
My problem is...please check as many as you need and if your problem is not on the list please add it at the bottom!
worried about a school situation
worried about a home situation
having trouble with another student (or a group of students)
having trouble with an adult
I need to see you...
as soon as possible (huge problem)
sometime today or tomorrow (medium problem)
sometime this week (medium - small problem)
Never submit passwords through Google Forms.
This form was created inside of Coppell ISD.
Terms of Service