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    Student Counseling Request

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    The student is requesting a counseling session with Mrs. Willard to discuss either their school work, themselves, family, behavior, friends, or a private matter, conflict, or bullying situation. They indicate whether it is an emergency, very important, or can wait. They provide their first name, last name, teacher, and date to schedule the session.

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    Student Counseling Request

    Uploaded by

    api-249224383
    583 views1 page
    The student is requesting a counseling session with Mrs. Willard to discuss either their school work, themselves, family, behavior, friends, or a private matter, conflict, or bullying situation. They indicate whether it is an emergency, very important, or can wait. They provide their first name, last name, teacher, and date to schedule the session.

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    student counseling request

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    The student is requesting a counseling session with Mrs. Willard to discuss either their school work, themselves, family, behavior, friends, or a private matter, conflict, or bullying situation. They indicate whether it is an emergency, very important, or can wait. They provide their first name, last name, teacher, and date to schedule the session.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    583 views1 page

    Student Counseling Request

    Uploaded by

    api-249224383
    The student is requesting a counseling session with Mrs. Willard to discuss either their school work, themselves, family, behavior, friends, or a private matter, conflict, or bullying situation. They indicate whether it is an emergency, very important, or can wait. They provide their first name, last name, teacher, and date to schedule the session.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Sunset Ridge Counseling Program

    Student Request for Counseling


    Dear Mrs. Willard,
    I would like to talk with you about:

    ___my school work

    ___myself

    ___my family

    ___my behavior

    ___my friends

    ___something private

    ___a conflict

    ___a bullying situation

    This:

    ___is an emergency
    (someone is getting or may get hurt)
    ___is very important (no one
    is getting hurt but I cant stop
    thinking about it).

    ___can wait
    (just something Id like to talk about
    sometime).

    Provide more information for Mrs. Willard below:

    __________________________________________________
    __________________________________________________
    __________________________________________________
    First Name:_________________ Last Name: _____________
    My teacher is ________________________ Date: _________

    Sunset Ridge Counseling Program


    Student Request for Counseling
    Dear Mrs. Willard,
    I would like to talk with you about:

    ___my school work

    ___myself

    ___my family

    ___my behavior

    ___my friends

    ___something private

    ___a conflict

    ___a bullying situation

    This:

    ___is an emergency
    (someone is getting or may get hurt)
    ___is very important (no one
    is getting hurt but I cant stop
    thinking about it).

    ___can wait
    (just something Id like to talk about
    sometime).

    Provide more information for Mrs. Willard below:

    ____________________________________________________
    ____________________________________________________
    ____________________________________________________
    First Name:_________________ Last Name: _______________
    My teacher is ________________________ Date: ___________

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