Contact Us | Faculty & Staff Assistance Office

First Name

Last Name

your age

My affiliation is:*

BU Faculty
BU Staff
Family member or partner of BU employee
Other

BU Family member name and relationship - Required Information Please

My department is:

My work title is:

I have been seen at FSAO before:

Yes
No

I prefer to be contacted via*

email
phone
data motion secure email (requires an account and password)

My E-mail address is:*

My phone number is:*

I prefer to meet with a counselor

on the phone
through Zoom
in person

I would like to schedule a*

Counseling Session – 45 min
Well-being Visit - 20 - 30 min
Mental Health and Well-being Checkup - 30 - 45 min - with a screening questionnaire review
Consultation (please briefly indicate issue for consultation in comment field below) - up to 45 min
FSAO Presentation for department/group

I feel the need to speak with someone

Within one day (We are in the office Monday through Friday. )
Within three days
Within a week
Within two weeks

Comments: (please note: We recommend that you do not include personal health information in this field. If you would like to share health information, please call our office at 617-353-5381 to speak with someone confidentially. )

Name

This field is for validation purposes and should be left unchanged.