Self-Referrals - Circle of Care

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Self-Referrals

If you find yourself in need of assistance, please contact us by completing this form. Once you submit the form, it will be sent to the Circle of Care Team. Your form will be reviewed and given to a team member who has the skills to meet your needs. This individual will contact you within two business days.

As a student seeking assistance you have the right to:

  • Respect and dignity without judgement.
  • Privacy. Your information only will be shared with individuals who will directly assist you. Your request for assistance will not be attached to your academic records in any way.
  • Accept all, partial, or none of the resources offered.
  • Request a different team member.
  • Have all potential outcomes explained to you.

Self Referral Form

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