7th Grade School Counseling Request Form
Please use this form to request an appointment with Ms. Jacobs. Do NOT use this form if it is an emergency (you or someone you know are in danger). If it is an emergency, please notify your teacher and report to the front office. Ms. Jacobs will contact you via Schoology to schedule an appointment. Request will be viewed on school days 8:00am-3:00pm. 
Email *
Student's First Name *
Student's Last Name  *
1A Teacher Name  *
The reason for your request is *
Are you or someone you know in danger? (If responding yes to this question, please notify your teacher and report to the School Counseling office).  *
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