Counseling Center Forms

Spend Less Time in the Waiting Room - Print your own forms

The intake forms can be downloaded, printed out, and filled out manually but students should not attempt to email them to the Counseling Center because of confidentiality reasons. Email is not a secure medium. Students should hand deliver any paperwork with personal information directly to the Counseling Center.

Forms

• Short Intake Form (PDF)
• Full Intake Form (PDF)
• Disclosure Statement (PDF)
• Information Release Form (PDF)
• Insurance Form (PDF)

There are two forms that we use for intake. The Short Intake Form (PDF), called the Phone Intake, is the one we ask students to fill out in order to decide who or what services they need.

The Full Intake Form (PDF) is a much more comprehensive form that we ask students to fill out and bring with them to their first meeting with a counselor.