JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Counselor Contact
Request an appointment with a Ms. Zell (6th Grade & 7th A-L) OR Ms. PT (8th grade & 7th grade M-Z)
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What is your Name? (Parents, please list your student's full name and then your name)
*
Your answer
What is your Grade Level?
*
Your answer
What is your Student Number?
*
Your answer
Choose a Counselor (We are a team and work together)
*
Ms. Zell (6th Grade and 7th Grade students whose last names begin with the letters A - ZL
Ms. PT (8th Grade and 7th Grade students whose last names begin with the letters M - Z
First, is this an emergency? Counseling Emergencies may consist of: thoughts of self-harm or suicide, harming others, abuse, unsafe at home, concern for a friend's safety, and others. Listed above are just some school "emergencies".
*
yes
no
Maybe (?)
Please give us a quick description of how we may help you?
*
Your answer
Please give us a time that you are not in class so that we may contact you without interrupting your learning? If is an Emergency, type "Emergency"
*
Your answer
Is there anything else you think we should know?
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
