Schedule a Peer Counseling Session with an SIC Staffer
You are always welcome to drop in for counseling during office hours, or email us at to schedule a private appointment, but we recognize that these options may not be ideal for everyone who seeks counseling.

If you fill out this form, the SIC will contact you to set up a session. Counseling can happen during regular office hours in the SIC, but they can also happen in a separate room and/or at other times. We can work with your schedule to find a time, a place, and a staffer that works best for you.

With kind regards,

Name (optional)
Your answer
Pronouns (optional)
Your answer
How should we contact you to set up a counseling session? *
E.g., phone # (for text or call), email, etc.
Your answer
Is there a particular staffer you'd like to meet with?
Your answer
If yes, would you also be comfortable talking to another staffer?
Are there any staffers you'd prefer not to meet with?
If yes, that's okay! We recognize that you may not feel comfortable meeting with a particular staffer or staffers for a variety of reasons. You do not have to disclose your reason.
Your answer
What are some dates and times that work for you? *
Please write at least 2 times that work for you. You are welcome to list times during our office hours, or outside of office hours - either way is OK!
Your answer
Where would you prefer to meet? *
Feel free to list ANY location that would work best for you!
I have the following access needs for the counseling session:
Your answer
Is there anything else we should know?
You are welcome to specify the counseling topic here, or anything else you'd like us to know - but you may also leave this section blank!
Your answer
Never submit passwords through Google Forms.
This form was created inside of Oberlin College. Report Abuse