Request an Appointment with Mrs. Ricke
Please note that I do not check this form or my WCUSD5 email account outside of school hours.
If this is an emergency, please contact the appropriate authorities or a trusted adult whom you have immediate access to.
What is your first and last name?
Which school building do you attend?
Waterloo Junior High School
Waterloo High School
What is your concern? Please check all that apply.
I would like to meet again about a concern we previously discussed.
I’m overwhelmed with my classes and/or commitments.
I feel depressed and/or anxious.
I don't know how to deal with my anger.
I am dealing with grief.
I need help with an important decision.
I need help coping with something hard.
I have a conflict with another person.
Someone at school is being disrespectful to me.
I'm having trouble with a romantic relationship.
My family is having a hard time.
I'm worried about someone else.
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