Parent/Guardian Counselor Appointment Request Form

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The BCMS Counseling Department in collaboration with students, parents, staff, and the community will provide a comprehensive school counseling program that aligns with national and state standards. We will provide a supportive, safe, and nurturing environment to assist all students in reaching their potential, becoming life-long learners, and productive citizens. Our School Counseling Program will provide an array of services to address student’s academic, personal/social, and career needs.

Parent Name: *

Student Name: *

Student Grade Level: *

Counselor contact- (2025/2026 school year) *

Mrs. Augustin- 6th

Ms. Gathright- 7th

Mrs. Hevener-8th

Ms. Carney- Career Counselor

Mrs. Robertson- Intervention Counselor

Mr. Jarod Lindner- Student Success Coordinator

Best Phone Number: *

E-mail address: *

Preferred Method of Contact: *

Phone

No preference

Reason for Meeting: *

Grades/Class Concerns

High School Options

Referrals (Tutor List, Counselors, Community Resources)

Scheduling

Family Concern

Student Concern

Career Counselor Information

Other

Required

Please explain (be as specific as possible): *

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