Request to see the Counselor
What is your last name?
What is your first name?
Who is the counselor you would like to see?
Mrs. Wiest 6th grade Counselor
Mr. Huber 7th grade Counselor
Ms. Rossi 8th grade Counselor
What is the reason for requesting to see the counselor?
Please check all that apply.
A friend is hurting themselves
Drugs or Alcohol Related
Please elaborate on your reason from above:
For example if you marked Academics, please tell us what about academics that you would like to talk about with the counselor.
Please check which period(s) you have an elective.
What grade are you in?
Please note: Counselors only respond to this form between the hours of 8am and 4pm on School Days. If this form is completed after hours, or not a school day, and is an emergency please tell an adult or call 911.
Send me a copy of my responses.
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