Request to see Miss Albin / Note to the Counselor
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If this is an emergency, Go to the office or tell a teacher IMMEDIATELY
Student Name OR may report bullying anonymously by leaving it blank
What is today's date?
What Grade are you in
I am a parent/Guardian
How soon do you want to meet
I really need to talk today
Tomorrow is ok
Whenever you get a chance
Will you tell me a little about what you want to meet about? (Select all)
I need help with grades / learning /organization
Friend issues / Drama / Some kind of Conflict
Need help with how I am feeling
Something at home
I am concerend about someone else (friend, family, etc)
I want help finding my future career
Anything you want to add?
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