Editing previous response:

Please fix the highlighted areas below before submitting.

Ms. Roberta Brown, School Counselor

I would like to check-in!

Connecting with you is important to me. I will be in touch as soon as possible.

Please complete the form below. Required fields marked with an asterisk *

Date:*

Answer Required

First Name:*

Answer Required

Last Name: *

Answer Required

Grade Level:*

Answer Required

Your email*

Answer Required

My concern is about:*

Answer Required

Friends

Family

School

Self

Other

If you selected Other above:

Answer Required

Additional Information

Answer Required

I would like to check-in with you:*

Answer Required

By Email

In person

REMEMBER THE FOLLOWING IMPORTANT INFORMATION:

If at ANY TIME you or someone you know is in crisis, or if you have any concern for the safety of yourself or someone else, CALL 9-1-1 IMMEDIATELY. Police officers are trained to conduct wellness visits and have the resources to connect individuals in need with appropriate services.

Confirmation Email

Confirmation Email *

Email Required