School Counselor Contact Request Form - Parents/Guardians
Hello Mustang Parent/Guardians
If you would like us to contact you or your student please complete the following questions.
Please remember that if this is a medical/mental health emergency to please call 911. We will be checking the responses on this form daily but give us 24 hours to reach out.
We would also like to remind you that school counselors practice confidentiality when working with your student, everything discussed is confidential unless your student discloses that they are/plan to hurt themselves, others, or someone is hurting them (physically, emotionally, and/or sexually).
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Student's First/Last Name *
Your First & Last Name *
Your Relationship to the student *
Grade *
How would you like the counselor to contact you? *
If you would like a phone call or email please provide the phone number/email you would like us to reach you at:
Please check the best dates to contact you *
MM
/
DD
/
YYYY
Please choose the best time to reach you *
Time
:
What topic would you like to talk about: *
Required
Please provide us a short summary of what your concerns are. *
I understand that the school counselor may not receive this request immediately if this is a crisis please contact emergency services at 911. I also understand that anything discussed with the school counselor or anything my student discusses with the school counselor is confidential unless I or my student discloses that they want to or are hurting themselves or others or is being hurt physically, emotionally, or/and sexually. *
Required
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