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CAPS Appointment Request

In a mental health emergency do not complete this form. Call:

If you'd like to schedule an appointment at CAPS for a non-emergency please complete the following form:

Current Address
Home Address
Emergency Contact (Must be over 21 years old)
CAPS Information
Schedule an Access Appointment
When are you are available to attend counseling? Please select at least 4 options. More times will make it easier to schedule.