I came to see you - School Social Work



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I came to see you!

My Name: _______________________________________________

My Teacher’s Name: __________________________________

I am…

⃝ Worried about school

⃝ Worried about home

⃝ Having trouble with another kid

⃝ Having trouble with an adult

⃝ Trying to do better but it’s hard!

⃝ Confused

⃝ Missing someone

⃝ Can’t concentrate

⃝ Having a problem that is not on the list

I need to see you…

⃝ Right away!

⃝ When you have time

Note: _____________________________________________

_____________________________________________

I came to see you!

My Name: _______________________________________________

My Teacher’s Name: __________________________________

I am…

⃝ Worried about school

⃝ Worried about home

⃝ Having trouble with anotࠀࠂࠄࠆher kid

⃝ Having trouble with an adult

⃝ Trying to do better but it’s hard!

⃝ Confused

⃝ Missing someone

⃝ Can’t concentrate

⃝ Having a problem that is not on the list

I need to see you…

⃝ Right away!

⃝ When you have time

Note: _____________________________________________

_____________________________________________

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