If you would like to schedule a meeting to talk with a Mental Health Counselor, please complete the form below and then submit. Upon receipt of this request, a Counseling Center representative will contact you to discuss the details of your request. Please provide the Counseling Center with several times you are available. Thank you!


Name: *

                                                                                    ID#: *   


Email: *


Phone: *


Best-Days to Meet:


Preferred Times: *