Request to Connect with Student Services

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Please complete this form to request an appointment with a counselor or social worker. We will call you down to speak with us as soon as we are able.

This form will be monitored intermittently during school hours only.

If this is an emergency, do not wait for a response, find a trusted adult to get help.

Email *

Your Last Name *

Your First Name *

Your Grade Level: *

7th Grade

8th Grade

Reason for visit: *

Academic Concern

Personal Concern

Family Concern

Friend Concern

Anxiety or Worry

DO NOT FILL OUT THIS FORM FOR A SCHEDULE CHANGE REQUEST. FILL OUT THIS FORM INSTEAD. https://forms.gle/GbLUnp51VNv3N9Rb9

You would like to see: *

Mrs. Oliver (Counselor-7th Grade)

Mr. Laird ( Counselor-8th Grade)

Mrs. Nelson (Social Worker-both grades)

Whoever is available soonest

Are you concerned about your or other's safety? *

Yes

If there is additional information we need to know before we contact you, please share it here.

Submit

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