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Request To Chat with Ms. Tara Monzet Wellness Center Counselor
Thank you for reaching out! I look forward to helping you connect to resources and support.
Please complete the following information if you would like assistance from the Wellness & Guidance Center. If this is an emergency, please contact 911 immediately.
If you or someone you know someone needs immediate help, please call or text the National Suicide Prevention Lifeline at 988.
Caver Wellness & Guidance Center Hours:
Monday through Friday (during the school year)
8:00am through 4:30pm
Please note
self-referrals are monitored Monday through Friday during the academic year and I will follow-up as soon as possible.
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* Indicates required question
Email
*
Your email
First and Last Name of Student
*
Your answer
Student ID Number
*
Your answer
Referring Person
*
Self referral
Staff/Teacher Referring
If Staff/Teacher referring please enter name and relation to student
Your answer
Grade Level
*
9
10
11
12
Is student aware of the referral
*
Yes
No
Other
Best phone number to reach you (XXX) XXX-XXXX
Your answer
Strengths and Interests (things you like or that make you happy)
*
Your answer
On a scale of 1-5, how you are feeling ?
*
Struggling, I'm Feeling Awful
1
2
3
4
5
Amazing, I'm feeling Great
I would like to discuss
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Group Counseling
Individual Counseling
Coping Skills/ Mindfulness
Bring Change to Mind Club ( Mental Health Awareness)
Other:
Current Concerns:
*
Safety Concerns (Please get immediate assistance--Call 911 or National Suicide Prevention Lifeline at 988
Depression
Anxiety
Social Withdrawal
Alcohol/Drug Use
No or Limited Motivation
Attendance
Bullying
Irritability
Other:
Required
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