Request Outreach Services
Students requesting outreach services must first have the approval of a faculty/staff member who has reviewed the request. Due to the many responsibilities of Center staff and the large request for services, we must require a minimum of 10 audience members at each function. Requests received at least three weeks in advance with at least three prioritized “choice dates” have a greater likelihood of being accommodated. If you would like to access any of the outreach services provided by the Counseling Center, please complete the Outreach Request Form below. We also encourage you to familiarize yourself with the Friends Helping Friends Presentations offered every Spring Quarter by members of the Counseling Center’s Peer Educator Program.
Please wait a few moments to receive a confirmation message that your request has been submitted before hitting the "submit" button again. There may be a slight delay before you receive this message. If you do not receive a confirmation message after 1 minute, please use the PDF version of the form.
If the Outreach Request Form (below) does not work or you receive an error message upon completing it, please complete a PDF version of the form found here and submit via email to Dr. Milo L. Dodson at firstname.lastname@example.org or drop off at the Counseling Center front desk. Thank you.
Outreach Request Form