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STUDENT COUNSELING CENTER INITIAL COUNSELING INTAKE FORM (Please refer to the Confidentiality Policy for details)Personal Information NameStudent ID No. Date of Birth Address(mm/dd/by)Block:Street:S000Email
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Schedule an appointment with a qualified counselor
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Arrive at the counseling session on time
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Be honest and open with the counselor about your feelings and concerns
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Listen actively to the counselor's advice and recommendations
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Respect the confidentiality agreement and keep the information shared in the session private

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Adults who are experiencing mental health issues such as depression, anxiety, or stress
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Adults who are dealing with traumatic events or past experiences
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Adults who are struggling with relationship issues or family problems
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Adults who need a safe space to talk about personal issues and emotions
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Confidential - adult counseling is a private therapy session between an adult individual and a licensed counselor or therapist.
Adult individuals seeking therapy or counseling are required to file confidential - adult counseling.
To fill out confidential - adult counseling, individuals must provide personal information and details about their counseling sessions.
The purpose of confidential - adult counseling is to provide a safe and confidential space for adults to discuss and work through personal issues with a trained professional.
Information reported on confidential - adult counseling may include personal details, session dates, and progress updates.
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