Chaplain Check-In Form
This form is for Carey Harrisdale Secondary School Students.
We have created this form to help us stay in touch. As you adjust to ongoing changes, you may have times where you feel stressed or anxious and we want to make sure that you continue to have access to Chaplain support if you need it.
If you would like me to contact you and talk things through – please fill out this form.
* Required
Email
*
Your email
1. Your Name
Your answer
2. How are you feeling today? (Tick all that apply)
Happy
Sad
Angry
Disgusted
Fearful
Surprised
Other:
Would you like me to contact you?
Yes
No
Clear selection
Which method of contact would you prefer?
Email
Direct Message
Clear selection
Is there anything you would like to share?
Your answer
Submit
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This form was created inside of Carey Baptist College.
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