COUNSELOR REQUEST FORM

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form is for STUDENTS to request the counselor.

Student Name ( First and Last )
*

Grade
*

Freshman

Sophomore

Junior

Senior

Why do you need to see the counselor? *

Personal

Academic ( Schedule Change or something academic related )

Rather not say

Other:

Any additional details to share?

Note: counseling requests can only be addressed during normal school hours. If it is after hours, the weekend, a holiday, or non-student day, your request will not be seen until the next school day. If you are having an emergency, please tell an adult or call 911 if necessary. If you have access you can also login to Clayful.

Call or Text 988 for the Suicide and Crisis Lifeline

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Jourdanton Independent School District.

Does this form look suspicious? Report

Forms