If you're anything like me, you sometimes feel overwhelmed by all the requests you get from students looking to check-in. I use this quick sheet to streamline and triage student requests for support. Whether you are a teacher, counselor, social worker, or another go-to person in the building, this is a helpful way to collect self-referrals for assistance. It includes five versions (counselor, social worker, and 3 generic options).
 
The simple questions with pictures for added accessibility help you understand who is requesting your support, when they requested it, the general topic, and how urgent it is. Not only does this make your life easier by prescreening, providing a paper trail, and reducing interruptions, it is a great way for students who may be reticent to ask you for assistance to get their needs met.
 
This is print and go! Simply print the version that you want to use, cut it in half, and distribute to students. I recommend making these available wherever makes sense (I do outside my office, in bathrooms, and at teachers' desks) and having a box or envelope where completed forms can be deposited.