Counselor Request Form
Hi Students,

Please complete this form if you would like to speak to the school counselor, Ms. Tina. I will try my best to check in with you as soon as possible, but if this is an emergency and you feel unsafe, please find an adult right away!

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Email *
Your Teacher *
Your First Name *
Your Last Name *
Your Grade *
I need help with: *
Required
How do you feel today? *
Required
What would you like to talk about? *
Submit
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