Stella Hills Student Request for Support
The answers you give are confidential. We will not share any information unless:

-Someone is hurting you
-You want to hurt someone
-You want to hurt yourself
-You give us permission to share this information with another trusting adult
Email *
Name
Who is your teacher? *
What grade are you in? *
How are you doing today? *
What do you need help with? *
Who would you like to talk to? *
Please describe you problem in detail *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of BCSD.

Does this form look suspicious? Report

Google Forms