Parent/Guardian Questions and Concerns

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Please fill out this form if you wish to speak with the counselor regarding your scholar. This form is confidential and protected for your scholars privacy. Your request will be reviewed and the counselor will contact you as soon as possible.

If this is an Emergency or Crisis please call 911

CRISIS Hotline: 24/7
(800-273-8255)

Scholars Name *

Teacher *

Your name and relationship to scholar

Best time to contact you *

Morning (9am-Noon)

Afternoon (Noon-3pm)

Evening (3-6pm)

Anytime

Other

Preferred method of contact to schedule a future call to discuss your concerns *

Text

Phone

Any

Phone Number *

Email *

Please describe your concerns and what you wish to discuss. Please include any additional background information you may find useful. *

Submit

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