"I want to meet with a school counselor!" Form
Please fill out this form to get in contact with a school counselor. We will get in touch with you and set up an in-person or online meeting if needed.
This is not required but it helps us find you faster.
With whom would you like to meet?
Mr. Cady-Russell (6th Grade)
Ms. Hilary (7th Grade)
Ms. Emory (8th Grade)
How urgent is this situation?
1) Very urgent!!! I need to see you RIGHT AWAY!
2) Important - I would like to see you sometime TODAY.
3) Essential, but I CAN WAIT for another day.
What do you want to talk about?
Identity (racial, gender, orientation, etc.)
Substance use (alcohol, drugs, etc.)
Self-harming thoughts or behavior
A situation I feel unsafe about
Something I don't want to write down here...
What type of meeting or response would you like?
Online Meeting with Google Meet
Text through Remind (If you are signed up for this)
If you would like a phone call or text, what phone number should we use?
Anything else you'd like to add?
Never submit passwords through Google Forms.
This form was created inside of Portland Public Schools.