GHS School Counselor Referral Form

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GHS School Counselor Referral Form

The form below helps you to see a school counselor. Please fill it out and the school counselor will send you a response with an available time. If an emergency exists please contact or call a trusted adult, If you have an urge to self-harm or are having suicidal thoughts in this moment please call 988, SUICIDE Hotline (1-800-273-8255) or text HOME to 741741 Crisis Text line.

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What grade are you in? *

What is your gender? *

Please type your first and last name. *

How are you feeling right now? *

Which counselor are you requesting? *

What is your reason for wanting to see the counselor? *

What ASCA counseling area is your appointment for? *

Academic (Grades, classes, etc.)

Personal/Social (conflict, anxiety, bullying/harassment)

Career (College/Jobs)

Thank you for your sign-in to the Google Form. The school counselor will be in touch with you when she/he is available. *

I confirm that I have read this message.

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