Counseling Referral
If you need to contact Mrs. Wald, please fill this out. She will contact you as soon as possible. Responses will be checked Monday-Friday from 8:00AM-4:00PM Thank you!
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Type of Concern
Brief Description of Concern:
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What steps have you taken to try and help yourself in this situation or problem?
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Please rate how serious/ urgent your problem is (0= it can wait, 5= needs immediate attention)
What is the best way to reach you? (Email, Phone, FaceTime, Microsoft Team) *
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