CCMS Appointment Sign Up (Confidential)

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CCMS Appointment Sign Up (Confidential)

Please fill out this form if you need to meet with your counselor. For class change requests you must fill out the class change form which can be found here or a hard copy is available in the counseling office.

Once you fill out the form and return it to the counseling office we will call you down. A $10 charge will be posted on your powerschool account for class changes made two weeks after the start of school, unless it was an error made by the school counseling staff.

Who is filling out the form?

Student at CCMS

Parent/Guardian of a student at CCMS

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First Name *

Last Name *

Name of student if parent/guardian filling out form

Grade of Student (current or upcoming if summer) *

8th

9th

Counselor to Visit *

Amber Fjeldsted (Last names A-E)

Shannon Hatch (Last names F-M)

Ali Thacker (Last names N-Z)

Purpose of Visit (Check all that apply) *

Emergency (Safety for me or another person)

Personal Concerns

Parent/Guardian requesting to see counselor

CCR (College Career Readiness)

Academic advisement

Class Change (Class change form must be filled out and returned before appointment)

Appointment requested by counselor

Other:

Required

Additional information (Specific information for reason above)

If it is an emergency outside of school hours call 911 or 988 (suicide and crisis lifeline) or download the SAFEUT app (in google play or app store)

For additional information refer to our website https://counselingccms.weebly.com

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