JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
School Counselor Meeting Request
If you need to meet with Mrs. King, please fill out this form and I will get with you as soon as I can!
If this is an emergency/crisis situation, please come to the office to see me.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name (First and Last)
*
Your answer
What is your concern regarding?
*
Personal Issue
Problems with Friends/Other People
Problems at Home
Academic Issue
Other:
Required
Urgency Level
*
Not urgent
Kind of urgent
Urgent (You want to hurt yourself; Someone else is hurting you; Someone else is hurting themselves; You want to hurt someone else)
Can you tell me a bit about what's going on?
*
Your answer
When is your study hall?
*
1st Period
2nd Period
3rd Period
7th Period
8th Period
9th Period
I don't have a study hall
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Jefferson Local Schools.
Report Abuse
Forms