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Counselor Request Form
Your Student Services team is here to support you! Please complete this form and someone from Student Services will be in touch with you.
6th & 7th Grade: Ms. Goemaat at
amber.goemaat@jeffco.k12.co.us
7th Grade: Ms. Tersigni at
tricia.tersigni@jeffco.k12.co.us
7th & 8th Grade: Mrs. Brownlow at
jenna.brownlow@jeffco.k12.co.us
Social-Emotional Learning Specialist: Ms. Whipple at
erin.whipple@jeffco.k12.co.us
If you or someone you know is in crisis, please dial 911, call the Colorado Crisis Hotline at 1-800-273-8255, or contact Safe 2 Tell at 1-877-542-7233 or
safe2tellco.org
.
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Email
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Your email
Student Name (First & Last)
*
Your answer
Grade
*
6th
7th
8th
I would like to talk to the counselor about:
*
Schedule: Missing Class or Incomplete Schedule
Schedule: Wrong Class Level
Schedule: Already Taken Specific Class
Schedule: Question about Class Placement
Schedule: Other
Personal Concern
Other:
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