2020-2021 JAY SEA Request to See Counselor Form
Please complete the following questions to request a meeting with your counselor. We strive to respond to requests within 48 hours.
Call 911 if you are having thoughts of hurting yourself or others or know of someone who is having these thoughts.
* Required
Email address
*
Your email
Grade Level
*
9th
10th
11th
12th
Campus
*
JAY
SEA
Student ID (the number you use for your lunch account or to check out a book)
*
Your answer
Email address
*
Your answer
Telephone number
*
Your answer
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Type of Concern
*
Academic
Personal
College, Career, Military Readiness
Other
Name of person completing this form and your relation to the student (write "self" if you are self-referring)
*
Your answer
Send me a copy of my responses.
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