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.
* Required
Email address
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Grade
*
9th
10th
11th
12th
How are you feeling today?
I feel great
I feel okay
I don't feel that well
Other:
Clear selection
Reason for Request
*
Academic
Social-Emotional or Personal or Home Environment
Career/College Readiness
Other:
Briefly State Reason for Request
*
Your answer
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
by phone
by zoom
Please provide best email/phone number:
*
Your answer
Send me a copy of my responses.
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