Requesting Counseling / Social Work Services
Email address *
In case of an emergency, do NOT wait for a response. Contact 911 immediately. 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. *
Your answer
A description of your concern (please include all relevant information). *
Your answer
Best way for us to contact you (phone number, email address) *
Your answer
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