Mrs. K-J's Virtual Check-In
I'm so glad you are here!

This is a VOLUNTARY check-in.  Students are NOT REQUIRED to do this, but I would love to hear from you!  

The answers you give are completely private and will only be seen by the counselor.
Your well being and safety is a priority.  Please submit the form when completed.


Thank you for checking in with me!

Love,
Mrs. K-J
Madison Elementary School Counselor
Sign in to Google to save your progress. Learn more
Student Name: First and Last Name *
(Pick One) *
How are you feeling? *
How did you sleep? *
Would you like talk to Mrs. K-J? *
Captionless Image
Do you have any questions, worries or concerns that you'd like to share with the counselor? (Remember it's completely private)
Counselor K-J's Confidentiality Statement:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Muscatine Community School District. Report Abuse
Google Forms