Counselor Request Form
Your Student Services team is still here to support you! Please complete this form and someone from Student Services will get in touch with you within 24 hours. Student Services' office hours are 8 AM until 3 PM and they can also be contacted via email. If you are struggling with homework, please contact your teacher directly.
6th Grade: Mr. Ruppert at
7th Grade: Ms. Yacobucci at
8th Grade: Ms. Tersigni at
Social-Emotional Learning Specialist: Ms. Whipple at
If you or someone you know is in crisis, please dial 911, call the Colorado Crisis Hotline at 1-800-273-8255, or contact Safe 2 Tell at 1-877-542-7233 or
Name (First & Last)
I would like to talk to the counselor about:
My Schedule/Academic Concern
I don’t need a check-in but just wanted to say, "Hi!"
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This form was created inside of Jefferson County Public Schools.