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Connect with Ms. Barther
Please answer the questions below to request a time to meet with your counselor. Please give your counselor 1-2 school days to respond. IF THIS IS AN EMERGENCY, DO NOT FILL OUT THIS FORM. PLEASE COME TO THE COUNSELING CENTER IMMEDIATELY.
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* Indicates required question
Referred by:
*
Self
Faculty or Staff
Parent/Guardian
Other:
What is your email address? (student or referring party)
*
Your answer
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student's ID Number
Your answer
What is the best description of the purpose of this request?
*
Academic (grades, attendance, etc.)
Schedule
Personal Concerns
Social Issue (conflict, relationship, etc.)
Other:
Required
What is the student's mobile phone number?
Your answer
What is the student's most frequently used email address?
Your answer
Is there anything else you would like me to know prior to our meeting?
Your answer
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