Outreach Request

If you would like the VSU Counseling Center to present an outreach program, please complete the form below and then submit. Upon receipt of this request, a Counseling Center representative will contact you to discuss the details of your request. Please provide the Counseling Center at least TWO WEEKS notice before an outreach event. Thank you!

COVID-19 Update: Throughout the Fall 2020 semester, The Counseling Center will be offering outreach services in a virtual format. Outreach presentations will be offered both in a live format via Microsoft Teams and through prerecorded videos found on our YouTube page.

• Name *
• Email *
• Phone *
• Department *
• Role on Campus *
  Faculty
  Staff
  Student
  
• Anticipated Date (allow at least two weeks) *
• Location of Outreach Program *
• Preferred Time *
• Length of Outreach Program *
  30 min
  45 min
  1 hour
  +1 hour
  
• Requested Topic *
  Anxiety/ Test Anxiety
  Body Image/ Eating Disorders
  Conflict
  Depression/ Suicide Awareness
  Diversity
  Introduction to Counseling Services
  Leadership Skills
  Relationships
  Self-Confidence
  Sexual Assault/ Domestic Violence
  Stress
  Substance Abuse
  Time Management/ Study Skills
  
• Estimated Number of People Expected *
• Audio/ Visual Equipment Available in Room? *
  Yes
  No
  Unknown
  
• Special Accommodations Needed
• Security Captcha: *