HCOS - Request to See a Counselor

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Interested in meeting with a virtual school counselor? Please fill out the form below and the appropriate counselor will get back with you as quickly as possible to assist.Remember, all questions with an * are required.

Last Name *

First Name *

Student ID Number *

Email Address (for students: can be a personal OR hcps.us account) *

Parent/Guardian/Learning Coach Name (if being filled out on behalf of a student)

Referral Source (who is filling out this form?) *

Parent/Guardian

Learning Coach (K-5)

Teacher

Student (myself)

Other:

Grade *

Reason for Request *

Friendship

Home Issue

School Issue

Question regarding virtual AP course

Difficult feelings (ex: sadness, anxiety, anger)

Other:

Required

Any Additional Information:

Submit

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