RHS Support Request Form:
Please use this form to refer a student for Intervention and Support Services. Information will be kept confidential.
Para los padres que necesiten el "Google Form" en español, pueden encontrar el enlace debajo:
I am a :
Student's Grade Level
Heather Graham (A-Bro & all IT Academy Students)
Elia Negrete (Brp-Caq & all ELL Students)
Carla Rivas (Car-Garb)
Ashley Gonzales (Garc-J)
Lauren Figueroa (K-Ne)
Salvador Garcia (Nf-Sal)
Rebekah Ames (Sam-Z)
Counselor is unknown
Academic Concerns (check all that apply):
Grade of "F" in more than two classes
Excessive tardies/absencses (not engaged in online courses on a daily basis)
Refuses to do homework
Lack of preparation
Lack of motivation
Defiant to teacher
Social-Emotional/Behavioral Concerns (check all that apply):
Attitude or behavior
Substance abuse (alcohol, tobacco, or drugs)
Defiant of authority
Harassment of other students
Fighting and/or provoking a fight
Mental Health Concerns (please explain):
Briefly explain the reason for request:
Have other interventions/supports been offered and/or implemented ? Please explain:
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Kern High School District.