JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Meridian Help Slip
Please fill out my virtual help slip if you would like to talk to a counselor. If you are having a mental health or life-threatening emergency, call 911 or go to the nearest hospital. Talk to a trusted adult or call the Crisis and Access Hotline (888) 724-7240 if you are not able to wait before I can respond. Thank you!
* Indicates required question
Email
*
Record my email address with my response
Your Name
*
Your answer
Email
*
Your answer
Check the box that applies
*
Student
Parent or Guardian
School Staff
Today's date is
*
MM
/
DD
/
YYYY
If you are a Parent/Guardian or staff, what is your student's name
Your answer
Phone Number
Your answer
Thank you for reaching out!
When you click submit, your school counselor or a school staff member will contact you.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Cajon Valley Union School District.
Report Abuse
Forms
