Request to meet with a wellness counselor
Students: Please fill this out if you would like to check in with a wellness counselor.  Someone will contact you within a week for a one time check in, so please check your email.
Parents/guardians: If you are filling this out on behalf of your student, please include your contact information and a wellness counselor will be in touch with you. Please also include if you student is aware that the request was made.  
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Email *
Student's first and last name as it appears in power school *
Student's preferred name if different from above
Grade level *
What is the best way for the counselor to contact you?   *
Any other information that would be helpful to know *
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