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General Counseling Request

Please complete the questions below. You will be contacted within two business days via email after submitting the request to schedule an appointment.

We look forward to meeting with you!


I agree to receive occasional text messages from UIRC (Not in regards to confidential information).
Check all that apply.
We will do our best to schedule you with your requested therapist, but may not be able to depending on schedule availability.
Check all that apply.