Social/Emotional Check-In Request for Mrs. GarciaSalas

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Students, please use this form to request your counselor to reach out if you are in need of social/emotional support during C-19, or at any other time you are in need of support. Answer a few questions to help us determine your need. For all other academic or scheduling needs please email your counselor directly. If you are experiencing a life-threatening emergency, call 911.

Your email address will be recorded when you submit this form.

Email *

What is your name? (First and Last) *

What is your ID number? *

On a scale of 1-10, 1 being really negative and 10 being extremely positive, how do you feel right now? *

Please check the boxes the most apply to you: *

I'm having a hard time and I just need someone to talk to

I need help accessing resources for me and/or my family

Other, I do not need emotional support and I will email my counselor directly for help with my academic concerns at kateri.sisneros@aps.edu or text (505)369-6178

Required

Would you prefer a call, text or email? *

Call

Text

What is your phone number or email? *

Did you know that RGHS has a Health and Wellness website dedicated to Mental Health resources? Copy and paste this link to check it out: https://riogranderavens.aps.edu/counseling?utm_source=schoolloop&utm_medium=badge&utm_content=counseling *

No, but I do now

Yes, I knew about it

I will check it out while I wait for a response from my counselor.

Do you already have a social worker? *

No, does not apply to me

Yes, my social worker is Alicia Sanchez

Yes, my social worker is Valerie Rogers

Yes, my social worker is Emma Clapp

A copy of your responses will be emailed to the address you provided.

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