Bromfield Help Line
Are you in need of assistance in dealing with a personal or interpersonal issue? If so, please fill out this form and we will try to assist you in getting the help you need.
If you are experiencing a mental health emergency, are having thoughts about harming yourself or suicide or harming someone else, please let a trusted adult know immediately and proceed to your local emergency room or call 911.
Community Health Link Mobile Crisis: 800-977-5555
National Suicide Prevention Lifeline: 800-273-8255
What type of issue are you dealing with
School related concern
Home related concern
Concerned about a friend or family member
Please describe the challenge you are dealing with.
Please describe any ideas you may have as to how we might help you in dealing with this challenge.
Please identify a way that we might communicate with you about any information or support services that might be helpful.
What grade are you in?
What is your name?
Never submit passwords through Google Forms.
This form was created inside of Harvard Public Schools.