Request to meet with a RBV Peer Counselor
If you would like to request to see a RBV Peer Counselor or refer students to a Peer Counselor, please submit this form and a Peer Counselor will contact the student directly.
Email address *
Student ID number
Your answer
Student Last Name *
Your answer
Student First Name *
Your answer
Grade *
Reason for Request *
Person Referring *
Please indicate which period you/student would like to be called out of. *
Please indicate if you would like to see a specific Peer Counselor by writing in their name below.
Please let us know if there is anything else you want to share.
Your answer
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