Counselor Request Form

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Please complete all the questions below if you would like to meet with your counselor. Your counselor will reply to you within a 1-2 days from Monday to Friday between 8:00 a.m. - 3:30 p.m. Any message sent after 3:30 p.m. on Friday will be read until the following school day.

What is your first name? *

What is your last name? *

What is today's date? *

YYYY

What grade are you in? *

7th

8th

What is the reason you would like to see your counselor? *

Question regarding my schedule.

Need help with a personal problem.

Need help with a peer conflict.

Question regarding high school.

Question regarding college.

Other:

How urgent is your request? *

Very, I need to speak with you today.

Average, I need to see you soon.

Low, anytime you can call is okay.

Submit

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