Want to speak to your student's school counselor? Fill out this form.
Please fill out the following check-in. I would love to hear from you!  Your responses will be sent to Mrs. Amber & Mr. Tom to follow up with you preferred method of contact within 24 hours.  

I am available Monday through Friday from 8:00am-3:30pm and will respond to you by email or by phone.

**Important Information**
This form is for non-emergencies only. If it is an emergency (thoughts of harming yourself or others), do NOT contact your school counselor.  Instead you can call the following numbers for help:

Call 911
Crisis Text Line: "HELLO" to 741741
Call the National Suicide Prevention Line: 1-800-273-8255
Trevor Project Lifeline (Available 24/7; Confidential Suicide Hotline for LGBT Youth): 866-488-7386

Please understand that confidentiality cannot be guaranteed via phone conferences. I will make every effort to ensure a confidential conversation but I will notify appropriate individuals if any of the following come up in our conversation:
1. Someone is hurting you.
2. You want to hurt someone.
3. You want to hurt yourself.
4. You give us permission to share with another trusting adult.

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Parent/Guardian's Name: *
Phone Number and/or Email Address: *
Your Student's First and Last Name: *
Please provide your preferred way for me to contact you.  Provide phone number and/or email address. *
When would you prefer to be contacted? *
Concerns that you have regarding your student *
Please let me know of any questions, worries, or how I could provide support for you as a Parent/Guardian not mentioned above. *
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