Intake forms 

All forms are currently being reformatted to meet the University's accessibility standards. Please contact the Psychological Services Center to receive copies of these forms while these edits are being made.

Please print all forms and bring the completed documents to your first appointment.

  • Intake information
  • Service policies
  • Notice of Privacy Practice
  • Consent for Psychological Service
  • Financial Agreement

Patient Information forms

  • Client Satisfaction Survey
  • Request for access to records
  • Complaint regarding health information
  • Restrict use or disclosure request
  • Amendment request
  • Alternative means of communications
  • Accounting disclosure