BSHS Counseling Office Appointment Request Form
IMPORTANT: This is not an emergency service.*  This form is for requesting non-urgent appointments only, such as for scheduling questions, academic issues, or general concerns. Form submissions will be reviewed during school hours. Response times may vary based on student needs and counselor availability. 

*If you or someone you know is experiencing a crisis situation, do not use this form.
 During school hours: Immediately contact the office or see your counselor in person. 
Email *
Student Last Name  *
Student First Name  *
My Counselor is.... *
I'm having a problem with..... *
Please explain what you would like to discuss
Day and time you are available for your counselor to call you down *
On a scale of 1(small) - 5(emergency), This problem is a..... *
A copy of your responses will be emailed to .
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