The Preparing for your Telehealth Appointment form provides information about preparing for your telehealth visit including location, technology, privacy, appearing on camera, what to have available at your first appointment, and starting your appointment. 

Counseling Services has provided several frequently used forms for you to review. Please see the below for an explanation of each form’s use, and a link to download the form.

Paperwork

Authorization to Release Records The Counseling Office does not disclose any information about a student without their written permission. (Please see our Confidentiality Policy.) If you would like someone to be able to communicate with the Counseling Office about your treatment, you must fill out an Authorization to Release Records form. You may come in to the Counseling Office and fill one out, print it from this website and bring it to the Counseling Office, or your counselor can send you the form to complete within My Medical Locker. 

Health-Counseling Practice Info This form provides students with information about our office practices and procedures. 

Protected Health Information This notice describes how information about you may be used and disclosed and how you can get access to this information.

Social Media Policy This notice describes information about our social media practices and procedures. 

Notice: Completing paperwork does not constitute treatment, or the beginning of a treatment relationship with a mental health provider. Your paperwork will not be reviewed by a Counseling Services provider until you arrive/sign in for your appointment. If you are in need of immediate assistance, please call Counseling Services during business hours at (859) 572-5650, or to speak to a licensed provider after hours call (859) 572-7777 (NKU University Police).