Schedule an Appointment with a School Counselor

I would like to see a School Counselor

Student Name 

           Grade:               Team:  

Academic Concerns                                21st Century Scholar Program

Friend's / Peer Issues                              Schedule Changes

Other Concerns   (please provide details)

Crisis                      (please enter details)

Your counselor will send you a pass to see you at their earliest convenience.

**If this is an emergency and you feel that you or another person is in
immediate danger/harm, please seek help from an adult immediately.
If this request is being submitted after school hours and is an emergency,
please dial 911.

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