Is this an urgent issue? (does this involve your safety or the safety of others) *
Required
If you answered 'Yes', please make sure you speak to the secretary for an immediate appointment. If this is not an urgent issue, please continue completing the form.
Your answer
Counselor *
Required
Do you leave the building during the day? *
If you answered yes to the question above, please check any periods you are NOT here. (Post Secondary Students, Compact Students, early release, etc.)
Reason for appointment *
Required
Feel free to explain any specific needs you may want to share.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Wadsworth City Schools. Report Abuse