RBES School Counselor Contact Form 2020-2021

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This form is meant to contact Mrs. Tarcza or Mr. Merchant for assistance. You can also ask your child's teacher about talking with us and they will let us know. We will try to contact you as quick as possible, but please allow 48 hours during school days.

*This form is not monitored 24 hours a day. Should you have any immediate concerns about your child's mental health, please contact your doctor, emergency room, the SCDMH Community Crisis Response & Intervention team (1-833-364-2274I) or the National Suicide Prevention Lifeline (1-800-273-8255).*

Parent/Guardian Name:

Student's Name (name the student that you want assistance with, if you need assistance with multiple children please list all)

Homeroom Teacher

Grade Level of my Child(ren)

Phone number (please note whether we can call, text or both)

Best way to reach me:

Video Chat

Phone call

Clear selection

Best time/days to reach me:

I need to talk to a school counselor about:

Submit

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