Student Peer Mediation Request

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Request to meet with SVMS peer mediators.

Peer mediators are 10th & 11th grade students trained to resolve conflicts between students.

Mediation is confidential (private) unless we are worried about your safety or the safety of someone else.

For immediate help, please go to the counseling office.

* Indicates required question

First Name: *

Your answer

Last Name: *

Your answer

Grade: *

Choose

6

7

8

9

10

11

12

Short description of the situation or problem. *

Your answer

When are you available?

Check all that apply.

*

Before school

During lunch

During homeroom

Required

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