Request to See a Counselor
Thank you for visiting Northwestern High School Student Services office! Unfortunately, we are unavailable to see you right now, but you are our top priority! Please fill out this form so that we can call you down once we are available.
Email address *
In case of emergency, please call 911. Do not e-mail or leave voicemails for the school counselors if you have a concern regarding the immediate welfare of yourself or another NHS student. Please find a trusted staff member in the event of our absence. Mrs. Rarick and Mrs. Troyer have office hours from 7:05 AM - 2:45 PM Monday - Friday. Both Mrs. Rarick and Mrs. Troyer frequently check and reply to e-mail after hours and on weekends when their personal time allows, however this in no way guarantees their ability to respond to crisis e-mails or voicemails. This form is NOT a crisis line or system that is staffed 24/7.
First Name *
Last Name *
Grade *
Which counselor do you want to see: *
What can we help you with? *
How would you rate your need to see a counselor today?
If this is outside school hours, and your answer is "5" please contact an available adult immediately or call 911. This form is not staffed 24/7 and is not a crisis line.
I'd like to see someone today but my issue is not an emergency
I am concerned for the immediate well being of myself or someone else
What period is best for us to call you down (study hall would be the best choice)? *
Anything else you'd like us to know that might be helpful in our time together:
Never submit passwords through Google Forms.
This form was created inside of Northwestern School Corporation. Report Abuse