I want to see the Counselor (Students Only)
This form is for students who would like counseling support services, to support them. The counselor is here to support you with school work, school, friends, relationships, family matters, your identity, etc. If you are interested in talking to the counselor, please fill out this form and I will get back to you as soon as possible :).
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Email *
First and Last Name
Today's date?
MM
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DD
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YYYY
Current Grade
Parent email or phone number
Who are you filling this form out for?
Clear selection
If you choice that you are filling out the form for " A friend", please write your friends name.
I would like to talk to you about....
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In the space below describe your situation
In the space below write what have you done so far for help?
Has anyone helped you? If so who?
Is there anything else you would like the counselor to know?
Submit
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