INFO

Phone: 805-756-2511
Fax:     805-756-6525
counseling@calpoly.edu

8:30 AM - 4:30 PM | M-F
Building 27

Forms

 
FORM/request Description
Release of Information Authorization to release mental health information
Outreach Request Form Request a presentation from Community Prevention & Outreach Services Team
Request for Interview Form Request interview from Campus Health & Wellbeing
No Show/Late Cancellation Fee Appeal Form Request fee cancellation because of extenuating circumstances or an error
Change of Clinician Request Form Request to change mental health provider

 

 

Back to Top

Related Content

About Us

Contact Us

In Solidarity

In Solidarity

Meet the Staff

Meet the Staff