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I need to talk to the counselor!
If you would like to see the school counselor, please fill out this form!
Thank you!
Mrs. Contreras
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First and Last Name
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Your answer
Teacher
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Your answer
My problem is.... (check as many as you need)
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School š«
Family/Home š”
Friends š§š½āāļøš§š¾āāļøš§šæāāļøš§š½āāļø
Feeling sad š¢
Feeling confused š¤·š½āāļøš¤·š¾āāļø
Feeling scared š±
Feeling angry š”
Feeling nervous š¬
Something personal š
Other:
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This is...
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a small problem
a medium problem
a BIG problem
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