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Counselor Request
Student Request to see Mrs. Harvill
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* Indicates required question
Email
*
Your email
Student Name
*
Your answer
Grade
*
6th
7th
8th
I am --
*
on campus-AM
on campus- PM
on campus- all day
at-home
My problem is...
*
Worried about school
Worried about home
Worried about a friend
Having trouble with another kid
Having trouble with an adult
I'm feeling sad
Missing Someone
Can't concentrate
Having a problem that is not on the list
Other:
Please give me a short explanation about what you would like to visit about or what is going on.
Your answer
I need to see you...
*
Right Away, this is an emergency.
Sometime today, this is important but I am ok right now.
Sometime this week, I need to talk to you, but it can wait.
If you are a self-harm or suicidal crisis Call 911 immediately
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