Counseling Request Form

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Counseling Request Form

Please fill out all information before you submit.
THIS FORM IS NOT FOR SCHEDULE CHANGE REQUESTS. THIS IS NOT FOR EMERGENCIES.

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* Indicates required question

Email *

Your email

Student Name (First and Last Name)

Your answer

Student ID # *

Your answer

Grade *

6th

7th

8th

Choose Your Counselor *

Mrs. Lond 6th grade and 8th grade (M-Z)

Mr. Lowe 7th grade and 8th grade (A-L)

Mrs. Flores, Prevention Specialist

Mr. Lopez (All Grades)

Reason For Request *

Academic Assistance

Personal/Social Counseling

Career & College Counseling

Edge Coaching

Attendance

Other:

Required

A copy of your responses will be emailed to the address you provided.

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