Mental Health and Wellness Clinic

Fields with asterisks (*) are required.

Preferred contact information

Preferred contact information *
May we leave a message (if phone number)? *
May we leave a text message (if phone number)? *
Therapist Gender Preference (check all that apply; Although we value preferences we are training clinic and our therapists rotate on a semester basis, therefore cannot always guarantee requests)
Therapist Preference (please note, we may not be able to guarantee your preference at time of request given we are a training clinic comprised of graduate students at various stages of their education and training).
What is your preferred session time frames? (Please check all that apply) *
Number of preferred sessions *
Do you have a computer? *
Do you have internet access? *
Preferred modality *
Type of Service (check all that apply) *
Please check some of the main things you are experiencing (Check all that apply)

You do not have to be a Wayne State University student to receive services.

Are you currently a Wayne State University student?
How did you learn about us?
To participate in Telehealth services, it is necessary that you have reliable telephone/cell service and/or access to a reliable internet connection, and be able to meet in a private and quiet location. Please confirm that you have these capabilities.