Student Request to Meet Counselor Form
If this an emergency and outside of school hours, please call 911.
Student Name
*
Enter your First and Last Name
CIF/Student ID
*
Grade
*
--Please Select--
6
7
8
9
10
11
12
Select your Counselor
*
--Please Select--
Ms. Gray- Grades 6 & 7
Ms. Dickinson-Llaurado - Grades 8 & 9
Mr. Fernández - Grades 10-12, Last Names A-M
Ms. Farrell - Grades 10-12, Last Names N-Z
Urgent, Any Available Counselor
Priority of Request
Please understand the counselor will get back to you in a timely manner.
--None--
Normal
First Available Time
Urgent
This is a crisis
Best email or phone number to reach you?
Reason for Request
If reason for meeting is confidential, then type CONFIDENTIAL.
If this an emergency and outside of school hours, please call 911.