Lewis Student Support Request 2025-26

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If your concern is about harm/hurt to self, or harm/hurt to others, please report to the office ASAP.

The Lewis Student Support Service Team is here to assist YOU!

Students can request a meeting with a team member to talk about any of the issues listed below. Please fill out the entire form and click the submit button. Our team monitors the requests during school hours.

If you are in immediate need of support outside of the school day or on a weekend, please talk to a family member or a trusted adult. You can call the Access and Crisis Line at (888) 724-7240 where counselors are available 24/7. Or text the Crisis Text Line by texting HOME to 741741 to connect with a Crisis Counselor 24/7. Suicide Prevention Line (Call, Text, Chat) 988

Email *

Record my email address with my response

Student ID Number *

First Name *

Last Name *

Grade *

I need support for *

Conflict with friend or another peer on campus

Concerns with homelife

Bullying (Intentional aggressive behavior repeated overtime)

Improving my grades (organization, time management)

Improving attendance in school

Help communicating with teacher

School related stress (presentations, test anxiety, missing assigment)

Emotional challenges (anxiety, sadness, loneliness, stress, shyness)

Making and keeping friends

Other:

Type of support requested *

Check in with an adult on campus

Speak with a credentialed confidential counselor

Mediation with smaller group 1-2 students with adult

Circle- mediation with a bigger group

Support calling home or talking to a parent/guardian

Support with looking at my Power School Grades, Attendance, and Citizenship

Concern regarding a class and/or my schedule

Need Community Services Support (Homeless, Community Needs)

Supplies (notebooks, city bus pass, planner, backpack, clothing, etc.)

Request a conference with my teacher

Request a conference with my parent

Questions about Homework Center or Saturday School (not avail in online learning)

Required

Have you spoken to or received support from an adult on campus for this concern? *

Yes

If you have spoken to an adult already regarding this concern, please give the name of the adult you spoke to.

Who is your trusted adult on campus?

A trusted adult is any adult you could go to if you have a problem and you believe could help you. They are someone you believe cares about you. It does not have to be a teacher.

Send me a copy of my responses.

Submit

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