Walnut Student/Parent SSC request
This form is to request support from the Walnut Hills Student Success Center.

Please reach out to your/your child's grade level counselor BEFORE requesting support.

Please note that this is NOT a request for special education services. To request an IEP, please email scrugge@cpsboe.k12.oh.us. To request a 504, please contact bohmerM@cpsboe.k12.oh.us.
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Student's Name
Student's Grade
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Have your or your child met with your child's school counselor to discuss your concerns?
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Name of School Counselor
Please explain what you need help with and why you are seeking support from the SSC. The more details you can provide, the quicker we will be able to determine best supports. (If you are seeking a peer tutor only, please state that and be sure to state in which subject tutoring is needed.)
Your name and contact information (email/cell # for text/phone)
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