Request to Speak to My School Counselor

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IMPORTANT INFORMATION:

This form is not monitored after 3:30pm Monday- Fridays, on the weekends or holidays. IT IS NOT INTENDED FOR EMERGENCIES. If this is an emergency, please call the following numbers as needed:
- 911 if you are having an emergency
- National Suicide Prevention 24-hour Hotline (800) 273-8255
- Crisis Text Line: Text 741-741
- Trevor Lifeline (866) 488-7386
- NAMI- Warm Line (Emotional & Mental Health Support) (714) 991-6412
- GGUSD Wellness Toolkit: https://sites.google.com/ggusd.net/osess/ggusd-wellness-toolkit?authuser=0

Student's First and Last Name

Student ID #

Reason for contact

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