DBES Student Check-In Form
I'm so glad you're here!

Please note: This is a VOLUNTARY check-in. Students are NOT REQUIRED to do this, but I would love to hear from you!

Check in with me and let me know how you're doing. The answers you give are completely private and will only be seen by me - Ms. Doering.

Your well being and safety is a priority.  Please submit the form when completed. If you have an emergency, please call 911.

If you'd like to have a private phone call or video chat, let me know! :)

Love,
Ms. Doering
Deerfield Beach Elementary School Counselor
Sign in to Google to save your progress. Learn more
Today's Date: *
MM
/
DD
/
YYYY
Last Name *
First Name *
Grade *
Teacher *
How are you today? *
Would you like Ms. Doering to contact you for a check-in? *
Statement of Confidentiality
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms