Request To See/Speak with a School Counselor: Request for Assistance with Grades, Personal, Social, etc.

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Fill this out and a school counselor will contact you as soon as possible.

I am a: *

Student

Parent/Guardian

First Name *

Last Name *

Grade *

6th

7th

8th

I would like to see: *

Mrs. Esparza (6th grade counselor)

Mrs. Alvarado (7th grade counselor)

Mrs. Zamora (8th grade counselor)

I would like counselor to contact me *

In person

By email

Phone Call/Google Meet

How urgent is this: (please contact me....) *

LOW (sometime this week please)

MODERATE (within the next couple days)

CRITICAL (ASAP but it can wait until tomorrow)

EMERGENCY (Immediately, can't wait)

Regarding *

Academics (my grades, classroom concerns, etc.)

Personal (something at home, my life, etc.)

Social (my friends, relationships, etc.)

Comments:

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