ADED - Counseling Request

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If you would like to talk with the counselor, Miss Gonzalez, please fill out this Counseling Request in order to best assist you.

If you need to speak with someone immediately and it is outside regular school/office hours, please call the 24 Hour Crisis Hotline: 1 (800) 991-5272

Email *

Name (first and last) *

Reason for Counseling Referral (check all that apply): *

Academic Counseling

Transition Meeting (discuss next steps)

Goal Setting

College and Career Counseling

Social Service - Referrals to community agencies that can assist with personal problems.

Graduation Information

Discuss Financial Aid

Personal Counseling: Need to talk to someone but NOT an Emergency

Other

Required

Description of counseling needs: *

Additional Comments:

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