Spencerport High School CARE Team Connection

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Thank you for taking the time to connect a student with the Drug and Alcohol Counselor. Please know that your identity will be kept confidential. This connection will NOT be used to take disciplinary action against the student. Please see an administrator or counselor if you have a concern other than substance abuse.

What is your name?

Please note, this is OPTIONAL. Staff members, we would appreciate it if you please include your name. This will allow us to follow up with you if we have any clarifying questions. If so, please provide both First and Last Name.

Who would you like to connect? *

Please provide both First and Last Name

Grade Level *

How do you know this person? *

I am a peer/friend/classmate

I am a staff member

I am a Parent

I am a Community Member

Anonymous

Other:

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