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Counseling Check In
Please fill out this form as you check into the EHS Counseling office
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* Indicates required question
Email
*
Your email
Student ID#
*
Your answer
Last Name
*
Your answer
First Name
*
Your answer
I am here to see
*
Berry
O'Brien
Smith
Stiger
Zintzun
Clark
Nogueda
Foss
Day
Other:
Reason for visit
*
Academics
Anxiety
Bullying/Harassment
Career Information
College Application Help
Financial Aid
Group
Mental Health check-in
Personal/Family Crisis
Running Start
Social Conflict with another student
Other: Please answer next question
Other:
Required
I need assistance with:
Your answer
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