• UCC Home Page
• News from UCC
• Emergency / crisis Services
• Sexual Assault Website
• Refering A Student
• About UCC
  • General Information
  • In The Meantime
  • Time-Limited Therapy Model
  • Missed Appointments
  • Recording Therapy Sessions
  • Confidentiality
  • Patient Rights & Concerns
• Contact UCC
  • Location & Hours
  • Phone / Fax Numbers

---

• For Students

• Forms
•     Information Sheet
•     Informed Consent
•     Medical History
•     Release of Information
•     Release of Info - Admin
• Online Screening Tools
• Dear Dr. Ana-Lyze

---

• For Faculty/Staff
• For Parents/Friends
• Programs/Consultation
• Self Help
  • Helpful Information
  • Recommended Reading
  • WWW Links & Resources
• The Faculty
• Professionals in Training
• Professional Training Programs
  • APA Approved Predoctoral Internship
  • Postdoctoral Fellowships
  • Hotels and Maps
• Notice of Privacy Practices Statement
• University Health Service (UHS)

There is a UCC professional on-call 24 hours per day, 7 days a week, for emergencies

UCC Professional On-Call: 275-3113

Life Line: 275-5151

On Campus Security: x13

Off Campus Security: 275-3333

UCC is accredited by
The Joint Commission

Informed Consent for Treatment Form

The Informed Consent for Treatment Form is to be filled out for your first appointment only.

• Word Format: Informed Consent for Treatment Form


• Acrobat Format: Informed Consent for Treatment Form

Please send questions about the technical structure/operation to the UCC Web Master