New Client- Session Request

COLLEGE STUDENT-SESSION REQUEST

Welcome to COLLEGE TELEHEALTH! We have partnered with colleges across the nation to help support you in and beyond the classroom! We look forward to getting you started with our College Telehealth-Online Therapy
If we partner with your college, you will receive a predetermined number of approved sessions at no cost to you. Fees are waived for students currently enrolled and verified by one of our partnering schools. If you do not see your school listed, please click back and choose the private-pay request option.

✅ COMPLETE FORM: If your college is listed on the drop-down list of partnering schools, complete this form.

✅ ENROLLMENT VERIFICATION: College Telehealth will need to verify enrollment with your college. Once verified, we will match you with a clinician in the state you are physically located.

✅ EMAIL INTRODUCTION: College Telehealth will send you an email introducing you to your therapist. Communicate directly with your therapist to schedule.

✅ JOIN OUR CLIENT PORTAL: You will receive an email invitation to join our Client Portal and enter your information.

✅ CONSENT FORMS: In your personal dashboard, you will be asked to complete our New Client Intake Consent Forms. Please do this 48 hrs prior to your initial session.

If you need any assistance or have questions, please contact us directly at officemanger@virtualcounselor.com.
What College Do You Attend? *
Student ID Number *
Required for Verification of Enrollment
Are you a New Client?*

NewReturning
Name of Enrolled Program/Area of Study*
Ex: Psychology, Education, Technology
College Status*

UndergraduateGraduateOther

PRIVATE PAY SESSION REQUEST
We accept private payment for Outpatient Behavioral Health. We are considered (OON) Out of Network and do not accept insurance at this time. We are happy to provide you with a super-bill for submission to your insurance company for OON reimbursement.

✅ COMPLETE FORM: Please complete this form to request a clinician match.

✅ EMAIL INTRODUCTION: Virtual Counselor will send you an email introducing you to your therapist, likely within 24 business hours. Please communicate directly with your therapist to schedule.

✅ JOIN OUR CLIENT PORTAL: You will receive an email invitation to join our Client Portal and enter your information.

✅ CONSENT FORMS: In your personal dashboard, you will be asked to complete our New Client Intake Consent Forms. Please do this 48 hrs prior to your initial session.

✅ RATES: Due to their unique areas of specialty and demographic locations, our therapist rate ranges vary. Please discuss this during your initial consultation with your assigned therapist.

If you need any assistance or have questions, please contact us directly at officemanger@virtualcounselor.com.

Thank you! We look forward to getting you started!

Virtual Counselor & College Telehealth
Which do you prefer? *

SCHEDULING & POLICIES
Scheduling Process

Your assigned therapist will contact you via phone, email, and text to schedule with you. Please repond promptly in order to schedule. *If we are unable to reach you after 2-3 outreaches, we may consider your file inactive. If this occurs, please contact our office manager. Officemanager@virtualcounselor.com
3 Outreaches*

I Understand and Agree.
Client Portal & Intake Forms

You will be provided an email invitation to join our online Client Portal. Complete all intake documents 48 hrs PRIOR to your initial session. *We cannot proceed with sessions unless your forms are signed. Your session maybe cancelled without the proper forms.
Intake Forms*

I Understand and Agree.
24 Hour No Show Policy

If you would like to cancel a session, we kindly ask that you provide at least 24-hour notice. No Show sessions will count toward the number of approved session allowed by your school or EAP. If you are a private pay client, you will be charged the full session rate.
No Show Policy*

I Understand and Agree.

THANK YOU

We will review your request and will contact you win 24-48 buisness hours. Please look for a follow up email from us with additional information. (Don't forget to check your spam). Feel free to reach back out to us at anytime to check on the status of your request. officemanager@virtualcounselor.com
Should be Empty:

VIRTUAL COUNSELOR & COLLEGE TELEHEALTH

Preferred Therapist

COLLEGE STUDENT-SESSION REQUEST

PRIVATE PAY SESSION REQUEST

PERSONAL INFORMATION

SCHEDULING & POLICIES

Scheduling Process

Client Portal & Intake Forms

24 Hour No Show Policy

THANK YOU