Belleville East Counselor & Social Worker Request
This link is for students or parents of a student that may be struggling academically or emotionally and would like to be connected to a counselor or social worker.

Email address *
Please share your name. *
Which Campus do you or your child attend? *
What kind of support do you need? *
Required
Check each staff member that you trust to talk to? *
Required
What's the best way to contact you? Please leave detailed instructions. Example: Please contact me on my cellphone. (618) 555-0201 *
After submitting this form someone will contact me within 24 hours during the school week (Mon- Fri, 8:30AM-3:30PM if In -person Learning and 8:30AM-1:30PM if Remote Learning). If it's an emergency I know to dial 911. I can also contact The National Suicide Prevention Hotline at (800) 273-8255, text the Crisis Text line at 741741, or connect with someone at www.suicidepreventionlifeline.org. I also know that I can talk to a parent, guardian, or trusted adult if I'm in need of more immediate help. *
Required
A copy of your responses will be emailed to the address you provided.
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