Counseling Referral - Sauk Valley Community College

Confidential counseling is provided by Masters level clinicians (LCPC, LCSW, LPC).

Please complete this form or email counseling@svcc.edu to make an appointment. All requests are confidential.

Please don't fill out this input box.

First Name

Last Name

Student ID

Best Contact Phone Number

Email Address

Person Completing the Referral if other than Self

Preferred Method of Counseling

Video Appointment

In Person - On Campus

Either

Describe your Concern