SHG Counselor Referral

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SHG Counselor Referral

Requests will be answered in the order in which they are received during school hours, Monday-Friday, 8:00 AM-4:15 PM. Please do not put in multiple requests for the same issue. Thank you for your patience, I will get back with you as soon as I am able.

Email *

Teacher Name (Only if you are a teacher)

I am a

Parent

Student

Teacher

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Last Name

First Name

ID #

Grade Level of Student

1st

2nd

3rd

4th

5th

6th

7th

8th

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My problem is (check as many as you need)

Worried about school

Worried about home

Trouble with another student

Trouble with an adult

I keep getting in trouble

Missing Someone

Problem not listed

I am a parent that would like to discuss my child's behavior, attendance or academic growth.

I am a teacher.

When would you like the counselor to contact you? Please give me three different dates and times.

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