Request For Student Support
Please call the student's counselor, Dean of Students, VP, or dial 3029 to notify us that the student has been sent to the main office.  This form should be submitted within 10 minutes of sending students to the office.
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Name of referring staff member. *
Referring staff member's e-mail address *
Name of Student *
First and Last name. Be sure this is the name that is used on PowerSchool.
Select the Student's Counselor *
If this student has an IEP, who is their case manager? *
What date did the incident occur? *
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When did the incident occur? *
Where did the incident occur? *
Describe the specific behavior requiring assistance. *
Parent / Guardian Conversation *
We understand that at the time of writing this request, you may not have had the opportunity to have a conversation with the parent. But, the expectation is that you will.  If you cannot give us a summary of that conversation on this form, please follow up with an e-mail to a dean or a counselor.
What supports do you need from the office now? *
Required
What previous interventions have you used with this student *
Required
Is there anything else we should know?
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