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
- Permission 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 Forms
The Student Counseling Center adheres to very strong privacy guidelines. If you wish to request that information about your counseling records be released, look at the options below to determine which form best meets your needs.
To release information about your counseling records to off-campus individuals, download this form: Authorization to Use and Disclose Protected Health Information.
To request that information about your counseling records be shared with other offices on campus, download this form: On-Campus Release of Information.
Student Counseling Center is located in room 012 of Odell Residence Hall on the Undergraduate Campus.
MSC: 135
email counsel@lclark.edu
voice 503-768-7160
fax 503-768-8223
Student Counseling Center
Lewis & Clark
615 S. Palatine Hill Road
Portland OR 97219