SFHS Counseling: STUDENT Request
Thank you for checking in! Please complete this school counseling request form to request that Brandy can contact you. Your referral will be handled within 48 hours via email, phone, or zoom.
Note: Below are resources available should you find yourself or someone else in a situation where immediate mental health services are needed. If this is an emergency, call 911.
National Suicide Prevention Hotline --- 1.800.273.8255
Central Crisis & Suicide Prevention Hotline --- 1.888.506.5991
Crisis Text Line --- Text HOME to 741741
Please understand that confidentiality cannot be guaranteed in virtual meetings. The School counselor will make every effort to ensure a confidential conversation, and as always, if there is a concern that you may harm yourself or others, or that someone is causing you significant harm the appropriate persons will be contacted.
How are you feeling today?
I feel great
I feel okay
I don't feel that well
Reason for Request
Social-Emotional or Personal or Home Environment
Briefly State Reason for Request
I would like to talk to someone
Sometime this week
Within the next 2 days
As soon as possible
Please contact me
by student email
Please provide best email/phone number:
Send me a copy of my responses.
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This form was created inside of Southern Humboldt Unified School District.