Counseling Referral
Please complete this form and one of the counselors will contact you as soon as possible.

If you are thinking about harming yourself, please stop completing this form and call 911/seek help immediately. You can also access the "Say Something" reporting app here: saysomething.net.
Your name: *
email address *
What grade are you in?
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Have you spoken to your counselor before? *
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