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Contact Form
Please correct the errors indicated below and resubmit your form.
This form is for inquiries or feedback about Counseling & Psychiatric Services. This is not to be used for clinical treatment or requests. If you do need treatment, or refills, please call or visit CAPS during office hours.
Your Name
Please include your name.
Your Email Address
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Subject
Please indicate the subject of this contact
Message
Limit of 750 characters.
By checking the box below I recognize and understand that this is not a form of contact for clinical treatment or help in an emergency.
Yes, I understand
Please check the box.
