Click on the links below for the appropriate form:

School Health and Wellness Referral Form
Student Referral form: used to initiate an intake appointment for a student with H&W staff.  After completing the form, click "Submit" and it will automatically be sent to Brian Johnson, LPC, Health and Wellness Program Coordinator. 

Staff Counseling Request Form
Staff Referral Form: used to initiate an intake appointment for DC faculty and staff with H&W staff.  After completing the form, click submit and it will automatically be sent to Brian Johnson, LPC, Health and Wellness Program Coordinator.