Counseling Registration

BU Student Counseling Registration Form

* = mandatory field

 
 
 
 
 
Current Address
 
 
 
 
Who referred you to us?:
1. Please select the option below that best reflects the PRIMARY reason for your visit so that we can schedule you with the appropriate provider. You may select additional reasons for your visit in the next section: *
(Check all that apply)
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2. Please select any secondary reason(s) for your appointment (check all that apply): *
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