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.
Email Address *
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) *
Grade *
I would like to speak with: *
Required
Brief Description of Issue *
Optional: (Period you would like to be called down)
Clear selection
Submit
Never submit passwords through Google Forms.
This form was created inside of District School Board of Niagara. Report Abuse