Appointment Request Form (Readmit, Transfer, and SAP Appeals)

Student Information

Hello and welcome to the Counseling Center. 

Please complete the form below answering all questions.

Once you have submitted the request we will be able to schedule you an appointment.

A confirmation will be sent to your email. 

Be sure to check your email for appointment confirmation. 

Thank you! 

First Name
Last Name
Phone Number
Email Address
Date of Birth
Jnumber

Please provide your Jnumber including J This can be found in your admission letter.
What is your major?

Please provide below further details regarding your requested appointment.

If you need an evening appointment, please come to see us on the main campus during our drop-in hours from 5 pm- 7:15 pm. Monday-Thursday

Below please select 3 possible days and time blocks that you would prefer your appointment. You will be scheduled on one of your selected days and time frames with a counselor

Are there any additional details you would like for us to know?

Community College of Philadelphia

INFORMED CONSENT AGREEMENT

Please click below to view

CONFIDENTIALITY OF COLLEGE COUNSELING SERVICES.pdf
Click to View


Document was approved by Community College of Philadelphia Legal Counsel and Vice President of Academic Affairs and Student Affairs on 12/1/2016

Terms & Conditions

Counseling Appointments are scheduled for 60 minutes. After submitting a request, you will be notified of your session date, time, and provided the session link via email. Appointment confirmations will be sent to the email that you provided. Please be sure to check the email you provided for this confirmation. In the counseling office, your privacy and confidentiality are of utmost importance. We understand how difficult it can be to reach out to others in time of trouble, and we are here to help. Please remember that we respect your privacy and we expect you do the same. Please be considerate of appointment times. If an emergency comes up, that is okay, and all you need to do is to notify the counselor that you need to cancel within 24 hours — we thank-you for your ability to respect your appointment time. This service is intended for those that seek help with everyday problems or academic information and is not suitable for people that are currently suffering from an immediate crisis. If you are experiencing a serious crisis, please stop now and visit our counseling office, call 1800-273-TALK, or phone 911.
Required
Date