BHMS Counselor Request Form
Hello! Thank you for using this form. We look forward to chatting with you soon.

If this is a crisis, please call 911 or use one of the following resources:

Mental Health Partners 24 hour crisis line - 303-443-8500
Suicide Prevention Lifeline - 1-844-493-TALK (8255)
911
988 Suicide and Crisis Lifeline Hours: Available 24 hours. Languages: English, Spanish

¡Hola! Gracias por utilizar este formulario. Esperamos poder conversar contigo pronto.

Si se trata de una crisis, llame al 911 o utilice uno de los siguientes recursos:

Línea de crisis de Mental Health Partners las 24 horas: 303-443-8500
Línea de vida para la prevención del suicidio - 1-844-493-TALK (8255)
911
Sign in to Google to save your progress. Learn more
Are you a student, parent/guardian, or teacher? *
¿Eres estudiante, padre / tutor o profesor?
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Boulder Valley School District.

Does this form look suspicious? Report