Counselor Request Form

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Counselor Request Form

Please complete this form to request a meeting with your counselor. Once submitted, a counselor will call you in within the school day hours (8:10-3:35).

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What is your first and last name?

Your answer

What is your student ID # ?

Your answer

What grade are you in?

6th

7th

8th

Clear selection

Please choose a reason why you need to see a counselor:

Friend(s)

Family

School/Grades

Feelings

Other:

Clear selection

Is this an emergency?

Yes

No

Clear selection

Submit

Clear form

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