Intake Form

Request an Appointment

Making an appointment is a simple two-step process and will take you about 10 minutes. Both steps must be completed for an appointment to be made. All information provided is kept confidential. After we receive your request, a Student Counseling Center staff person will contact you within a week, typically by e-mail, to schedule your appointment.

Step one requests your times of availability. Appointments are typically 50 minutes. Step two requests information about how we can contact you, demographic information, your reason for seeking help and a brief questionnaire that will help us better understand how to serve you. Be sure to complete all steps. We look forward to serving you.

Emily K. Moore, LPC
Director, JBU Student Counseling Center


Step 1 of 2:

What days and times are you available to be seen by a therapist?: