Counseling Referral Request BHS
Thank you for visiting the Counselor Request Page. While school is being conducted remotely counselors are still available to support students’ social, emotional, academic, and college/career needs. All requests will be responded to as soon as possible via email. You may also request a zoom meeting with your Counselor or with Ms. Marwick in the College and Career Center. Note: If you need to talk privately with a counselor a parent/guardian will need to send a quick note of approval via email
***IMPORTANT: If you think you (or your child) are having a medical or mental health emergency go to the nearest hospital. Do not attempt to access emergency care through this website. You may also call the Benicia Police Department (707)745-3412 or 911 and ask for a "welfare check" and an officer can come to your home and provide transport safely to the hospital if necessary.
Here are some additional resources:
24 Hour Suicide/Crisis Hotline 1-800-273-TALK (8255)
CrisisTextLine.org | Text from anywhere in the USA to text with a trained Crisis Counselor: Text HOME to 741741
Peer-Run Warm Line (1-855-845-7415) is a non-emergency resource for anyone in California seeking emotional support via phone and web chat for problems around interpersonal relationships, anxiety, panic, depression, finance, alcohol and drug use, and more.
Please refer to the district website for more information.
Please write first and last name.
Enter again to verify. Please write first and last name.
Please check the box of your assigned counselor (if known)
Guenther (9th grade)
Keppel (10th grade)
Wallace (11th grade)
Smith (12th grade)
Marwick (College & Career Center)
Reason For Request
(Check all that apply)
URGENT Personal Issue
Non-Urgent Personal Issue
College and Career
Letter of Reccommendation
Discipline Follow-Up (Administrator only)
Briefly Describe the Reason For Referral:
Person Making Request
Friend or Peer
Preferred Periods to be Seen
(Check all that apply)
Zoom Appointment (parent/guardian must email counselor to give permission)
Check all that apply
American Indian/Alaska Native
Black or African American
Native Hawaiian/Other Pacific Islander
Race Not Listed/Other
Decline to State
Please list your email or phone number for contact and appointment scheduling:
Never submit passwords through Google Forms.
This form was created inside of Benicia Unified School District.