Student Request to See the Counselor

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Student Request to See the Counselor

This is a confidential form that the counselors will use to better serve you at school. This form will be checked regularly, however, filling out this form does NOT guarantee you will be pulled from class if seated. If Off-Site, we will email you to schedule a google meet.

CLICK HERE FOR: Transcript Requests

CLICK HERE FOR: Office Worker / Study Hall Sign in

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Assigned Counselor *

Rhein (Last Names A-G)

Thornton (Last Names H-Q)

Thompson (Last Names R-Z)

Last Name *

First Name *

Grade Level *

9th

10th

11th

12th

Please rate the URGENCY of your request: *

1 (Within a week)

2 (Important, preferably within 1-2 days)

3 (Urgent, but not emergency)

4 (Emergency) ex. Suicidal Ideation, statements of harm, cutting, feeling unsafe to go home

Category *

Academic

College or Career

Personal/Social

Area of concern? *

Personal Problem (anger, anxiety, depression, issue with others, home life, etc)

My Schedule

Virtual Arkansas Class Help

Graduation, Scholarships, or other career-related (senior stuff)

Counselor-Initiated Interview

New Student Enrollment

Other

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