Student Request Form to Visit School Counselor

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To allow for social distancing guidelines to be followed, students who wish to visit the school counselor's office need to fill out this form. Students will be called to the school counselor's office when the counselor is available after the form has been received and processed. If a student has an emergency, he/she is asked to tell his/her teacher to call the school counselor's office so that arrangements can be made to see the counselor ASAP.

Students are asked not to stop in at the school counselor's office to check in on the status of their appointment. Students can also contact the school counselor Ms. Jaros via email at jjaros@deerlakes.net with non emergency issues.

Student's FIRST name *

Student's LAST name *

Student's grade level *

grade 6

grade 7

grade 8

I am attending school *

brick and mortar (in school building)

remote (from home)

hybrid (in school building AND home)

Reason(s) for need to see the school counselor (mark all that apply) *

Academic Concern

Career Exploration Inquiry

Counselor Requested to See Me

Emotional Need

Family Issue

Grief and Loss

Organizational Issues or Assistance

Password Request for Skyward or Google

Peer (Friend or Classmate) Conflict

Personal Issue

Scheduling Question

School Supplies Requested

Social Issue

Student Request (Other)

Required

Submit

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