Request to Connect with Counselor Ms. E

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Please fill out this request form if you would like to connect with Counselor Ms. E.
*I will email your parent/guardian to set-up a check-in depending on your responses.*

Hi Hallinan Family. Although I miss seeing you and laughing together, I'm always here for you - whether to talk, share advice, celebrate gratitude, process feelings, connect your family to resources, or help you! You can fill out this form anytime you want to connect with me (we can Zoom, phone call, or email). Plus, I'd love to hear how you are doing 🤗Virtual high-fives, 🖤Ms. E

Email *

What is your First Name? 🧑‍🎓 *

What is your Last Name? 🏷️ *

I would like to talk to you about ____ 💭 (you may click on multiple options): *

my school work

my friends

my family

myself

my class

my emotions

I'd rather not say

Other:

Required

Which Grade are you in? 🏫

What is your Teacher's name? 👨‍🏫👩‍🏫

Is there anything else you would like to share with me? 📝

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