Counselor Check In
Lizzie is available to chat on Google Meet or Zoom with students or parents that request a time to check in through this form. Please fill in the information below and Lizzie will be in touch to confirm a date and time. If this is something that is urgent, please exit this form and talk to a trusted adult that is close to you. If this is an emergency please call 911.
Email address *
Date *
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DD
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YYYY
First & Last Name *
Please select one *
School Currently Attending *
How are things overall? *
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Excellent
How is school work going? *
Not good
Excellent
Please rate how your overall wellness has been since the transition to distance learning? *
Not good
Excellent
How are things at home since the social distancing began? *
Not good
Excellent
Primary area of concern *
What do you need help with? *
How would you like to be contacted? *
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