Request a Phone Meeting or Video Meeting From Your Counselor

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Dana students can submit this form to request a phone meeting or zoom video meeting from their school counselor. Counseling support will consist of a 30 minute phone or zoom session with the student. Students can select which day they prefer to schedule their meeting.

**Counselors must have the completed Dana Virtual School Counseling Consent Form completed by a parent/guardian to hold a phone or video meeting**

First Name & Last Name

Student ID Number

Current Grade Level

Clear selection

I am requesting a

Phone meeting from my counselor

Zoom meeting from my counselor

Clear selection

I would like to talk to my counselor because...

Please provide the best phone number to reach you:

The phone number I provided is:

My parent's cell phone number

My home phone number

My cell phone number

Other:

Clear selection

I would like my meeting to occur on a:

Monday

Tuesday

Wednesday

Thursday

Friday

Clear selection

Your counselor will call you ahead of time to schedule your meeting. Please look out for a phone call from an unknown or private number. Thank you and take care!

Submit

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