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General Intake

Intake Process

Students may schedule a counseling appointment in two ways:

Special Requests

We try our best to accommodate special requests (i.e. a certain counselor by name, or a counselor of a certain gender, ethnicity, sexual orientation, etc). Please note that you may need to wait longer for a special request if those counselors are not immediately available for new clients.

Preparing for Your Intake Appointment

Please arrive 20 minutes early to your initial appointment to complete some paperwork. This will include a demographic questionnaire, an informed consent statement, symptoms checklist, and a schedule of availability.

Release of Psychological Records or Information

Psychological records are confidential by law and are not released to anyone, including parents, spouse, friend, off-campus medical or mental health providers, and/or University personnel, without the written consent of the student.

A completed Consent to Release of Information form with student’s official signature is required before any psychological records can be sent, requested from, or discussed with a third party (off-campus mental health provider or facility, parent, other.). A notary verifying student’s (or former student’s) signature may be required.

Instructions:
  1. Complete the Consent for Release of Information (PDF 56KB).
  2. Include contact phone numbers in case there are any questions.
  3. Sign requested form. (We will be unable to process your request without an official signature. If the Cowell Center cannot verify the student’s signature and the student cannot come into the Center to complete the form, the Center will require the student to have the Consent to Release of Information form notarized.)
  4. Fax form to: (408) 554-5454