Forms

New Client Paperwork for Counseling Sessions

All forms should be completed on the LC Health Information Portal.  They can be found under Forms, Section 3: Student Counseling Center Forms.  If you’d like to review the forms or have trouble accessing the portal, click on the links below to download our new client forms.  These forms are typically required once an academic year.  

For a new appointment you will need to complete four separate forms:

• Student Counseling Center Informed Consent
• Personal Information Form
• Available Hours Grid 
• Consent to Record

Some of these forms are multiple pages, so you may want to print them double-sided in order to save paper.  

Release of Information Form

The Student Counseling Center adheres to very strong privacy guidelines.  If you wish to request that information about your counseling records be released to other offices on campus and/or to off-campus indidivuals: download, complete, and sign this Authorization to Use and Disclose Protected Health Information.