Schedule a Counseling Session

CASC | Counseling Services | Contact Us | Schedule a Counseling Session

Please complete the form below to schedule an in-person counseling session. We will contact you to confirm the appointment day/time. We will contact you by our next business day to schedule your appointment. Our business hours are Monday through Friday from 9-5.

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Email Address: *

Student ID Number: *

First Name: *

Last Name: *

Phone Number: *

Street Address:

City/Town:

State:

Zip Code:

Emergency Contact Name: *

Emergency Contact Phone Number: *

Appointment Needed: *

As Soon As Possible

Within One Week

Within Two Weeks

I am available to meet for a counseling session on this day / these days between the hours of 9-5: *

Monday

Tuesday

Wednesday

Thursday

Enter time available to meet on Monday:

Enter start time and end time (e.g. 9:00am - 12:00pm).

Enter time available to meet on Tuesday:

Enter start time and end time (e.g. 9:00am - 12:00pm).

Enter time available to meet on Wednesday:

Enter start time and end time (e.g. 9:00am - 12:00pm).

Enter time available to meet on Thursday:

Enter start time and end time (e.g. 9:00am - 12:00pm).

Leave this field blank

Cleveland State University

Engaged Learning

Schedule a Counseling Session