Telemental Health Services 

*DO NOT complete these forms unless you have been directed to do so by a UCC staff member.  If this is an emergency, please call 911.    

Due to our office providing telemental health services at this time, the UCC is asking new clients and existing clients to complete the paperwork below. 

STUDENTS:

• Step 1: Download your paperwork
  • Please click HERE to download the Telemental Health Consent Form 
  • Please click HERE to download the Initial Assessment Form – STUDENTS ONLY
• Step 2: Please read the forms, fill them out completely, and save them.

• Please fill out ALL of the information requested and note initials at the end of each page when indicated

• Step 3: Please upload your completed forms into the following link: Telemental Health Document Repository.  
• Step 4: Once completed, please call the UCC at 662-915-3784 to confirm that we have received your paperwork and schedule your appointment.

FACULTY/ STAFF:

• Step 1: Download your paperwork
  • Please click HERE to download the Telemental Health Consent Form 
  • Please click HERE to download the EAP Form – FACULTY/ STAFF ONLY 
• Step 2: Please read the forms, fill them out completely, and save them.

• Please fill out ALL of the information requested and note initials at the end of each page when indicated

• Step 3: Please upload your completed forms into the following link: Telemental Health Document Repository.  
• Step 4: Once completed, please call the UCC at 662-915-3784 to confirm that we have received your paperwork and schedule your appointment.

If you have any questions about this process, please email or call the UCC for guidance.