Virtual Counseling Help Slip
Please fill out this virtual help slip if you would like to speak to the counselor or refer. I will answer your request within the following business days on a first come first serve basis. 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 until I can respond. Thank you! - Ms. Bennici
Sign in to Google to save your progress. Learn more
Email address *
Check the box that applies to you *
Required
Your Name *
Your student's name (if parent or staff)
Your school *
Phone number *
I need to talk to you about *
Required
I am (or my student is) feeling *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Cajon Valley Union School District. Report Abuse