Request to See the Counselor, Mrs. Burton-Johnson -Students for Last Names M-Z

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Hi there, I look forward to assisting you as quickly as I can.
1. Answer questions completely so that your counselor can assist you.
2. Please give your counselor 24 hours to respond/send for you.
3. Please speak to an adult if you have an emergency (grief, suicide, cutting, bullying, domestic violence/abuse).
4. Report all emergencies to the counselors office immediately.

I am : *

Student

Parent

Teacher

Student ID# *

Email *

Full Name

What can I help you with? *

Peer Conflict/Relationship Concerns

Family Problems

Graduation

EOC/IGC

Career/Military Exploration

Dallas Promise/College Advising

If you or a friend is having feelings of depression, suicidal ideations, self-injury, or bullying, please go directly to the counselors office. This is not the appropriate reporting form.

Other:

Please give me a brief message about your need or concern. *

Please call me to your office or meet with me virtually.

Low: I need to see you this week

Medium: I need to see you in 1-2 days

High: I need to see you today

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