School Counselor Meeting Request
Use this form to request a meeting with Susie Honaker Wirzbicki
Your responses are private but not necessarily confidential since it is a Google form. 

If you have an emergency, please contact the Cedar office at 360-432-5492 during the school day and they will get me or Amber can help. 

If you have a mental health emergency outside of the school day, please contact one of the options below:
24- hr Suicide Lifeline 988
24-hr Crisis Text Line Text HEAL to 741741
24-hr Crisis and Resource Line 988
Teen Line Text TEEN to 839863
Trevor Project- LGBTQ Text START to 678678
Trans Lifeline 1-877-565-8860

Thank you for adding your email. It makes returning your message much easier. 
Sign in to Google to save your progress. Learn more
Email *
I have some social or emotional concerns that are getting in the way of my ability to do my best.  *
I need some help with resources outside of school.  *
Your Grade: *
Required
My concerns are about my academic plans or current classes.  *
Notes For Susie (optional) 
Your First and Last Name  *
My concerns are about my plans for after high school.  *
I do my very best to see you ASAP. If you have an emergency, please tell your teacher or the office. If it has been more than 2 days, please come by my office in the morning. Something must be up.  *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Shelton School District.

Does this form look suspicious? Report