Request an Appointment - Mr. Kelley
Use this form to request an appointment with your counselor. This form should NOT be used for emergencies. 

Once you submit the form, you will receive an email with your meeting date & time in 1-3 school days. 

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*If you are experiencing a mental health emergency or need to talk to someone while school is closed, please refer to the resources below:

Suicide Prevention & Crisis Lifeline: Dial 988
Crisis Text Line: Text “4HOPE” to 741741
Emergency Services: Dial 911

**If you are concerned about a friend, please tell a parent/guardian immediately as this form is not checked after school hours or while out of office.**
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Email *
First and Last Name *
Homeroom Number *
When are you free? Meetings should be scheduled before school, after school, lunch, or during study halls.  *
Required
Please indicate which periods you have study hall.  *
Required
What is this meeting about?  *
I understand that this form is a meeting REQUEST. I understand that I will receive my actual appointment date & time via email in 1-3 school days. 

If this is an emergency, please see a counselor immediately. 
 *
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