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Requesting Counseling / Crisis Team Services
Please use this form if you have concerns about your own health or safety, or the health or safety of another student.
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In case of an emergency, do NOT wait for a response. Contact 911 immediately. If you are experiencing a mental health related emergency, call 988. Response from WAVE staff may take between 24-72 hours. All information is confidential.
Student's name that you are concerned about (yourself or someone else).
*
Your answer
Name of the person completing this form (if not comfortable sharing, put anonymous)
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Your answer
A description of your concern (please include all relevant information).
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Your answer
Best way to contact you (phone number, email address)
Your answer
Best way for us to contact the person you are concerned about (phone number, email address)
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Your answer
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