Center for Health & Counseling

You should have created an appointment either in-person or over the phone. You can check your appointment information by logging onto the Patient Portal.

Please arrive 15 minutes early to your appointment to ensure all paperwork is up-to-date and submitted to your provider.

Please bring a payment method with you. We accept Visa, Mastercard and Discover. Cash in accepted, but it is helpful to have exact change. See the cashier services across the hall to break dollar bills if needed. If you cannot pay for your appointment, a hold will be placed on your account. *Please note, balances over $50 will be flagged and you will not be able to create future appointments without first paying down your balance.

Lastly, please be courteous of our staff’s time. If you arrive more than 10 minutes late to your appointment, the provider may reserve the right to not see you and you will lose your appointment slot. It is your responsibility to remember your appointment and arrive on time.

To cancel an appointment, we require 24-hour or more notice. There are 2 ways to cancel an appointment:

1. Call 801-957-4268 to speak with someone directly to cancel an appointment. If you get sent to voicemail, include your name, phone number, date and time of your appointment and reason for canceling.
2. Cancel your appointment on the Patient Portal.
   • Log into your account and scroll to the bottom of the page to view the appointment that you'd like to cancel. Click the cancel button. Notice: the portal will not allow you to cancel your appointment with less than 24-hour notice.
3. Please be courteous of our staff’s time. If you arrive more than 10 minutes late to your appointment, the provider may reserve the right to not see you and you will lose your appointment slot. It is your responsibility to remember your appointment and arrive on time.
4. Starting Oct. 3, 2022, accumulating two massage No-Shows will result in loss of eligibility for massage services for the remainder of the semester.

If you no-show (skip) a medical or counseling appointment without canceling or rescheduling 24 hours in advance, you will be charged a $10 fee. If you do not complete the patient paperwork prior to your appointment and are no early to do so, the provider may not see you and you may have to pay a $10 fee. To avoid fees, show up early to your appointments and avoid canceling your appointments last minute.

Our massage appointments are paid for in advance and are non-refundable. If you no-show (skip) your massage appointment you will not be eligible to have the amount refunded. See the Massage Therapy page for more information.

If your unpaid fees add up to $50 or more, you will need to pay down the fee before you can schedule another appointment. If you are having a hard time paying for your appointments, consider applying for our "fee waiver program" which provides 5 free medical or counseling appointments.

To remove fees, please visit one of our three locations and pay in person or pay over the phone via credit card.

• Minor Consent Form

Counseling Forms

• Counseling Intake Info
• Counseling Release of Information
• Counseling Minor Consent
• Counseling Individual Consent
• Counseling Supplemental Consent
• Counseling Couple Consent

Massage Forms

• Massage Intake (PDF)

Student Health Clinic Forms

• International Student TB and MMR Screening
• Merck Low-Cost Form (PDF)
• Low Income Eligibility (PDF)
• Glaxo Low-Cost Form (PDF)
• Medical History Form (PDF)
• Patient Rights and Responsibilities (PDF)
• Conditional Agreement (PDF)

Information Sheets

• Tuberculosis: Get the Facts (PDF)
• 2015 - 2016 Influenza (Flu) Info Sheet (PDF)
• Hepatitis A Vaccine (PDF)
• Hepatitis B Vaccine (PDF)
• Gardasil (HPV) Vaccine (PDF)
• Measles, Mumps, & Rubella (MMR) Vaccine (PDF)
• Pneumococcal (PPSV) Vaccine (PDF)
• Tetanus, Diphtheria, Pertussis (Tdap) Vaccine (PDF)

To obtain your counseling, medical, or massage records of information please follow the steps below:

1. Download, print, and complete the Medical Release of Information Form.
2. Once you have filled out the form, call 801-957-4268 during business hours to notify our staff that you are sending the form over fax. OR bring the form with you in-person. The form cannot be sent via email.
3. If you choose to send the form via fax, our fax number is 801-957-4341. If you choose to submit the form in-person, please visit one of our three locations during business hours.
4. Once the form is received, it will be viewed and attended to. It may take up to 15 days to complete the request. Please realize that this is not an instant process.
   1. For more information on health information, please visit HIPAA Privacy Rule and Sharing Information Related to Mental Health (hhs.gov)
5. Our staff will notify you when your records have been gathered. For additional questions, please contact us at 801-957-4268 or centerforhealthandcounseling@slcc.edu.

Note: You have the right to access your medical labs as soon as they are pulled. You do not need to fill out a Medical Release to obtain those records. Visit your student Patient Portal | SLCC account or sign into Quest Diagnostics.

We do not require or accept insurance other than GeoBlue for International Students. However, we do accept HSA cards as a form of payment. If you have questions or concerns about paying for your appointment, please give us a phone call 801-957-4268 or email Tatiana Schild, tschild2@slcc.edu.

Students experiencing financial hardships may apply for our fee waiver program which will provide current students with a total of 5 medical and counseling appointments free of cost. Students are eligible for 2 waivers per fiscal year (10 total appointments). To apply visit any CHC location and ask the front desk receptionist for a fee waiver. Once approved, the student can schedule an appointment an bypass the $15 fee. Waivers are typically processed by the CHC Director within 2 days.

HIPAA & FERPA Disclosure