RSMS Student Counselor Assistance Form
If you would like assistance from a Counselor or Mrs. Salinas, please complete this form. Once you submit the form either Mrs. Knight, Ms. Fairley, or Mrs. Salinas will email you as soon as they can.
What is your first and last name? *
Your answer
What is your ID number? *
Your answer
What grade are you in? *
Homeroom Teacher? *
Your answer
What is today's date? *
MM
/
DD
/
YYYY
I am...(check all that apply) *
Required
Describe your problem here. Please include names of people and details, if possible. *
Your answer
I need to see you... *
What is your email address (if you prefer to chat with a Counselor through email)?
Your answer
Who would you like to meet with? (Choose 1) *
Submit
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