Request to see Counselor
*IF THIS IS A CRISIS SITUATION REPORT DIRECTLY TO THE COUNSELING OFFICE*


Please use this form to request to see your counselor.


Mr. Tinsley First year 9th grade students


Repeat 9th - 12th grade

Ms. Bucavaz Last Names A - Cosb
Ms. Perlmutter Last Names Cosc - Holl
Mr. Smith Last Names Holm - More
Mr. Conners Last Names Morf - Sed
Ms. Wyche Last Names See - Z

First Name of Student *
Your answer
Last Name of Student *
Your answer
Grade of Student *
Email Address (email that you regularly use) *
Your answer
Phone Number *
Your answer
Who is the Counselor (listed above) *
Reason for request *
What is your question or reason for request? *
Your answer
What time of day works best for you? *
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