Kinoshita Counseling Referral Form

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If you're a student, parent/guardian of a student, or staff member and would like to talk to Mrs. Chutuk, you can use this form to let me know a little about what is going on and I'll get a hold of you.

Si es un estudiante, padre / tutor de un estudiante o miembro del personal y quieres hablar con Sra. Chutuk (la consejera de la escuela), puedes usar esta forma para informarnos un poco sobre lo que pasa y nos pondremos en contacto con usted pronto.

If this is an EMERGENCY and you do not have immediate access to a counselor, please speak to a trusted adult ASAP, call 911, or call the Suicide Prevention Lifeline: 1.800.273.8255.

Si se trata de una EMERGENCIA y no tiene acceso inmediato a un consejero, hable con un adulto de confianza lo antes posible, llame al 911, o llame a la Línea de Prevención del Suicidio: 1.800.273.8255.

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