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Sign in and let us know what you need help with.  Your responses will remain CONFIDENTIAL within our counseling department.
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Last Name *
First name *
What is your issue about? *
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On a scale of 1 - 5 How urgent is your need.  1 means it's not super urgent and you feel like you can "wait in line."  5 means your need is SUPER URGENT to your health and safety or someone else's health and safety. *
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Who are you hoping to have help from?
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Describe your issue briefly so that we can help make sure you get the help you need.
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