Counseling Concerns
Please print this page, complete, and leave on Elva Ocampo’s desk to schedule an appointment with your counselor.
Counseling Concerns
Name___________________________
Student ID #______________________
I would like to address one or more of the following concerns with my counselor:
___ Family Problems
___ Feeling sad, depressed, hopeless
___ Feeling nervous, worried
___ Peer pressure
___ Behavioral problems
___ Low self-esteem
___ Personal issues
___ Drug/alcohol issues
___ Attendance problems
___ Relationship problems
___ Schedule change
___ Other
Please return to the counseling secretary, Ms. Elva Ocampo, in the downstairs counseling office.
CLICK HERE to return to counselors’ email and phone numbers.

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