Counselor Request Form

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Please complete this form if you have a question for one of LMS's School Counselors. Please make sure to leave your contact information so that we can get back to you! We will check these forms Monday-Friday during regular school hours. We will try to respond to you in 24 hours during these times.

This form is not to be used for emergencies purposes. If you are being hurt by some one, thinking about hurting yourself, or you are worried that someone else might be hurt/ hurting themselves you need to tell the closest adult. If you need immediate help for an emergency please call 911. You can also call the NM Crisis Hotline at 1-855-662-7474.

If you leave a request on here for a situation we view as an emergency we are required to make contact with your family.

What is your name? (First and last name) *

Who is your question for? *

Mrs. Bauer

Mr. Romansky

Ms. Papadakis

Any counselor is okay

Is this an emergency? (Think: Is someone being hurt? If yes, you need to tell the closest trusted adult). *

Yes

Briefly describe your question/ concern *

How do we get a hold of you? (please leave an email and phone number) *

Submit

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