Helping out a friend
This form is set up to not collect your email address.

Thank you for caring for your friend and letting us know! Please check the US Counseling website to see mental health resources, and do not hesitate to come talk to your counselor whenever you need.
Sign in to Google to save your progress. Learn more
Your name (optional)
Who are you worried about? (please provide first and last name or initial of last name if possible) *
What grade is the student in? *
Required
What makes you worried about them? *
Required
Please describe what you have seen or discussed with this person.  *
On a scale of 1-5, how much of an emergency is this today?  *
Not immediate concern
In crisis today
Is there any other information you'd like to share?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ISP. Report Abuse