Parent Request for School Counselor/Social Work Support
The Student Services team is here to support the social/emotional, academic, and college/career needs of your students. If you have concerns and would like someone to meet with your child, please complete this form and click "submit". Your request will be sent electronically and the counselor or social worker will do their best plan to meet with your student in the timeframe indicated.
Thank you! - Mrs. Wiedmaier (counselor), Ms. George (counselor), and Mrs. Mansfield (social worker)
Your name (First and Last)
Relationship to student:
Student Name (First and Last)
Who would you like your student to meet with?
Mrs. Wiedmaier (Ms. Fraticola) (counselor for students with last names A-L)
Ms. George (counselor for students with last names M-Z)
Mrs. Mansfield (social worker)
What is the general reason you'd like your student to see a counselor/social worker?
Academic (current grades, credits, etc.)
Class Schedule Planning/Course Requests
Social/emotional or personal concerns (please email the counselor or social worker to describe your concerns)
Urgency (how soon do you need your student to be seen?)
Emergency (now)- Please call or email Mrs. Miranda at
so she can let us know right away that you need to be seen!
ASAP (my student needs to be seen today if possible)
Within the next 1-2 days
Within the next week
When convenient (no rush)
What is the best way to contact you? Please indicate below. (examples: school email, personal email , cell phone number- please indicate)
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Genoa-Kingston CUSD424.