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? *
What is your ID number? *
What grade are you in? *
Homeroom Teacher? *
What is today's date? *
I am...(check all that apply) *
Describe your problem here. Please include names of people and details, if possible. *
I need to see you... *
What is your email address (if you prefer to chat with a Counselor through email)?
Who would you like to meet with? (Choose 1) *
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