EDH Primary Counselor Request Form
Please fill out this form if you would like to be contacted by one of the school counselors. Please allow 24 hours for a response M-F while school is in session.

If this is in regards to an emergency, please call 911.

Confidentiality Statement:
When scholars speak with a school counselor, what they say is confidential. Confidentiality will be breached under the following circumstances:

*The scholar poses a danger to self
*The scholar poses a danger to others
*The scholar is being harmed by someone else  
This will continue to apply for phone and video appointments with the counselor. Due to the nature of phone and video conversations, confidentiality may be affected depending upon the scholar's location and access to privacy. Please notify the counselor if there will be barriers to privacy during your conversation or if you have any concerns.

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Email *
I am a: *
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Scholar's First & Last Name *
Scholar's Grade Level *
Scholar's Strengths
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