Norco High Student/Family Request For Assistance Form

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Please remember:

If you have an immediate concern, such as a student with suicidal ideation or self-harm, during the student school day, contact a counselor or administrator immediately. PLEASE keep the student with you until you have connected the student with a Counselor or Administrator.

If you need emergency assistance, dial 911, 988, 1-800-273-8255 (National Crisis Line), or go to the nearest Emergency Room.

Please allow 24-48 business hours for counselor to respond.

Email *

Your Name (name will be anonymous): *

Student's Name (concerned about): *

If more information is needed, contact me at:

Your relationship to this student:

Who is the student's counselor?

Mrs. Sanchez A - C

Mr. Bell D - I

Mrs. McKenzie J - M

Mrs. Toledano N - Sh

Ms. Turner Si - Z and AVID

Mrs. Motonaga - Intervention

Unknown

Clear selection

Grade Level (if known):

9th

10th

11th

12th

Clear selection

Student ID # (if known):

Reason(s) for request for assistance: *

Other important information that we should know about this student:

Submit

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