MCHS School Counseling Appointment Request

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Your MCHS School Counselors, Mrs. Cummings (formerly Ms. Stamer) and Mrs. Knighton, and our Germanna Community College Career Coach, Mrs. Beverage are available to meet in person at MCHS, video chat on Google Meet, or talk by phone with students who request an appointment using this form.

We are available in person and virtually M-T-TH-F and through virtual office hours only on Wednesdays. Virtual appointments are scheduled for 20 minute blocks and are for NON-EMERGENCIES.

**IF THIS IS AN EMERGENCY, please exit this form and talk to the nearest adult.**

Please fill out the information below and Mrs. Cummings, Mrs. Knighton or Mrs. Beverage will be in touch to confirm a date and time. 😊

Email *

First and Last Name *

Grade *

9th

10th

11th

12th

I would like to meet with *

Mrs. Cummings {formerly Ms. Stamer} (A-J)

Mrs. Knighton (K-Z)

Mrs. Beverage (GCC College/Career Coach)

My concern is about *

Academics

College or Career

Personal

Other:

I need to talk with you *

RIGHT AWAY!! (Right away=Big problem/emergency!)

Sometime today

Sometime this week

Counselor Initiated

The best way to connect with me is *

In person

By phone (please provide the best number to reach you in the Other box below)

Video Chat using Google Meet

Other:

Required

If you would like to connect in person, please indicate when you are available

I am in the building on my grade level day (Ex: I'm a senior & I come to school on Mondays)

I would like to schedule an appointment

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