Are you a NPMS student that needs to talk to your Counselor or Social Worker?

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This form is a request form that will get sent to your Counselor or Social Worker, so they can reach out to you with any questions or concerns!

Email *

First and Last Name: *

Your Team Name: *

6G-The Loons

6H- The Lynx

7D-The Gophers

7E-The Vikings

8A-Minnesota Aurora

8B-The Wild

What is the topic for your appointment? (check those that apply) *

Personal concern

A concern about a friend

Safety concern

Other:

Required

Please provide a brief explanation so we can be ready to address your questions or concerns. *

Timeline for communication from a Counselor or Social Worker? *

This is urgent: I'd like to talk to someone ASAP

This is high-priority: I'd like to talk to someone within 1-2 days

This is important: I'd like to talk sometime this week

Which method would you prefer to communicate? (check those that apply) *

In-person

Video conferencing with Google Meet (if you're quarantined)

Required

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This form was created inside of New Prague Area Schools ISD 721.

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