School (Guidance) Counselor Appointment Request Form
In order to schedule an appointment with your School (Guidance) Counselor, please complete the form below. Please be as specific as possible, so your counselor can respond appropriately.

PLEASE NOTE: If you are experiencing a medical emergency, have taken an overdose, or have harmed yourself in any way, DIAL 9-1-1 IMMEDIATELY

If you are having a psychiatric or substance abuse crisis and need assistance, please contact Mobile Crisis Intervention Services (MCIS): Northern Delaware Hotline, call: 800-652-2929
Student First Name *
Student Last Name *
I am a Christiana *
If Parent/ Guardian: First and Last Name
Email address: *
Best Phone Number You Can Be Reached *
Grade *
Counselor (if known) *
Select the Reason for Appointment (leave the details below). *
Details about appointment. *
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