23-24 Roosevelt Counselor Contact Request
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Email *
First name *
Last Name *
Grade *
How would you like your School Counselor to contact you? *
Please provide your phone number so that we can contact you. Please note: Our phone number may show as blocked.   *
What topic(s) would you like to talk about? *
I understand that my School Counselor may not receive this request immediately. If this is a crisis, please contact emergency services at 911.  I also understand that anything I talk with my School Counselor about is confidential, unless I disclose that I am hurting myself, someone else, or that someone is hurting me. *
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