BDSS Student Support Request Form
It is important for BDSS students to know the supports available to them, and be able to self-refer in a discrete way.
Please select your requested support from the list below and they will contact you as soon as they are able.
(Your request will be confidential to the In-School Student Success Team Staff)
THIS IS NOT AN EMERGENCY SERVICE - if you are in an emergency situation, please call 911 immediately. This service will lead to an appointment/conversation with student supports staff.
Please list a phone number where you and/or your parent can be contacted. Guidance appointments will be largely conducted by telephone to maximize health and safety for all. *
Student Name (First & Last)
I would like to speak with:
Student Success (Mrs. Badawey) Start here if unsure where to go for support!)
Guidance (Mrs. Lancaster - eg. timetable changes, course inquiries)
Youth Counsellor (Sue Hamilton - social/emotional supports and counselling)
Social Worker (Sarah Nepon - Select if you have seen her already, otherwise select Youth Counsellor)
Community Addiction Services Counsellor (CASON)
School Nurse (Joanne M.)
Resource Support (Mrs. Berg)
Principal/Vice-Principal (Mr. Wilson/Mrs. Orr)
Brief Description of Issue
Optional: (Period you would like to be called down)
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This form was created inside of District School Board of Niagara.