Request form - University Health Service

Explore an archive of orientation presentations and learn about the care and support provided by University Health Service, the University Counseling Center, and the Health Promotion Office.

To request a presentation, please complete and submit the form below. Our teams will review your request and respond within two business days. Thank you.

Requestor Name*
Requestor Email*
What school and/or department are you affiliated with?*
Who are you requesting to present?*
- Primary Care
- University Counseling Center
- Health Promotion Office
- Student Health Insurance/Mandatory Health Fee
Will this be held in person or virtually?*
- In Person
- Virtual
Location (if in person)
Event Title*
Event Description*
Event Date*
MM slash DD slash YYYY
Event Time*
Length of Presentation Time*
Are any other departments presenting during this session? If so, who?*
Audience Description (e.g. undergraduates, prospective students, MBA students,etc.)*
Expected number of participants*
Please provide any additional information we will need.*

Please contact University Health Service with any questions.