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:
What grade are you in?
Have you spoken to your counselor before?
Yes, Mrs. Buehler (last names A-G)
Yes, Mrs. Dimeo (last names H-P)
Yes, Ms, Cook (last names Q-Z)
Yes, Mrs. Lopez (school social worker, usually at WMS on Wednesdays)
Yes, I meet with Mr. Walker on Wednesdays
Yes, I spoke to a counselor but not sure which one
No, I have not spoken to one of the counselors
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This form was created inside of Union County Public Schools.