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
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

 

 

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