Student Counselor Assistance Form
Students who would like assistance from a counselor can complete this form, a Counselor or CIS Coordinator will connect with you as soon as possible.
What is your first AND last name? *
What is your ID number? *
What grade are you in? *
Homeroom Teacher? *
What is today's date? *
I am... *
Describe your problem here. Please include names of people and details if possible. *
I need to see you...
Clear selection
What is your email address? (if you prefer to chat with a counselor through email)
Who do you want to talk to? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy