CHS Counselor Appointment Request
In addition to the appointment sign-in sheet located outside our office, students may now request an appointment by completing the below information. As always, if urgent attention is needed, please contact us directly or contact the nearest teacher or school administrator.
Student Name: ( Last Name, First Name )
Please list your grade level for the 2020-2021 school year:
Student Contact Info: Please list your email address, if you would like to be contacted by email:
Reason I need to see my Counselor: Check as many as you need below:
Worried about something at home/family
Worried about school (classes, grades, graduation, ect)
Having trouble with another student(s)
Dealing with a personal problem
Need to discuss Program of Study, Academic or College/Career Plan
Is your safety or the safety of others at risk because of this issue/problem? *
I'm not sure
How much stress or worry is this problem causing you or others right now?? *
Very little (it is okay to see me within a week)
A LOT (See me as soon as possible)
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This form was created inside of CCBOE.