School Counselor Appointment Request Form for Students
This form is intended for use by STUDENTS ONLY.

NOTE: Schedule Review Requests should not be submitted on this form.

Parents/Guardians/Others who would like to contact a counselor, please do so by emailing your student's grade-level School Counselor directly. Please include your student's full name, your full name, and your student's ID number in any emails to their School Counselor

STUDENTS: Please complete the following information to request a meeting with your counselor.
The counseling department reviews requests at the end of each day and will touch base with you within 24 to 48 hours.

School Counseling Department
Grade 9, Rachael DeRosso:
Grade 10, Angela Higginbotham:
Grade 11, Suzan Harden:
Grade 12, Georgia Roberts:

**If you are experiencing a crisis or emergency, please report directly to the counseling office.

Student ID Number *
Your answer
Student First Name *
Your answer
Student Last Name *
Your answer
Grade Level *
I would like to request a meeting with: *
Please provide a brief description of the reason you would like to meet with your School Counselor. *
Your answer
Please select the reason(s) you would like to meet with your School Counselor. Select all that apply. *
Student Email Address *
Your answer
Student Phone Number
Your answer
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