| FORM/request | Description |
|---|---|
| Release of Information | Authorization to release mental health information |
| No Show/Late Cancellation Fee Appeal Form | Request fee cancelation because of extenuating circumstances or an error |
| Change of Clinician Request Form | Request to change mental health provider |
| Request to Decline Disclosure | Request that your records not be posted to your Health & Counseling portal |
INFO
Phone: 805-756-2511 (24/7 support available)
Fax: 805-756-6525
counseling@calpoly.edu
8:30 AM - 4:30 PM | M-F
Building 27
