Request to meet with your counselor or case manager:

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Please complete this form if you need to meet with your counselor or case manager.
*If you or someone you know is in crisis, please contact the closest adult in your home. The responses to this form are only checked during school hours (M-F 8:00 - 2:00)

Email *

Last Name (student) *

First Name (student) *

Homeroom (Teacher or Number) *

Counselor/Case Manager (please select who you want to meet with): *

Ms. Irwin (Grade 8)

Mr. Tedesco (Grade 7)

Ms. Corcoran

Ms. Faust

Ms. Pagano

Mr. Patrick

Ms. Pona

Ms. Seville

Ms. Brennan (Case Manager)

Dr. Hayes (Case Manager)

Mr. Lawrence (Case Manager)

Ms. Mattessich (Case Manager)

Ms. Holt (Case Manager)

Reason for Request? (please be specific) *

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