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Student Request to See Counselor
Students, fill this out and your counselor will contact you soon!
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* Indicates required question
Student Name
*
Your answer
What is your grade?
*
9th
10th
11th
12th
Which counselor do you see?
*
Ms. Flynt 9th/10th
Mrs. Johnson 11th/12th
What do you need to see your counselor about?
*
Academic Issue (grades/work load/studying/homework)
ACT
College/Career questions
Family Issues
GPA or Class Rank
Schedule Change (please explain in description box)
Graduation requirements or plan of study
Social Issues (friends/classmates/teammates)
Personal Issues
Request a Transcript
Other:
Required
Description: Please DO NOT put anything personal here. Only use this box to describe your schedule change or ask your question.
Your answer
How would you like us to respond to your question/request?
*
Email (please include your email address in the description box)
In person (at school)
If you are having suicidal thoughts/issues, please call the National Suicide Prevention Lifeline 1-800-273-8255 or visit the nearest emergency room. Our counselors do not check these forms after school hours (before 7:15am and after 3:00pm)
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