Forms

Student Counseling Services requests that all students seeking treatment fill out the background information forms prior to the initial appointment. These forms can be completed online at the following link:

Please go to VPN https://camelvpn.conncoll.edu/+CSCOE+/logon.html to login and then enter the following URL https://buttonbush.conncoll.edu/titanium_web/launch.htm.

Once the page opens, click on the tab for Intake. Please complete this "paperwork" prior to your initial appointment.

Due to confidentiality laws and ethical practice standards, NO information is shared with anyone outside the SCS offices. If the student requires information to be shared with a third party, they will be required to complete the below release of information form to authorize the release of information. Students who have questions regarding confidentiality can speak with the counselor at the time of the initial appointment or speak with the Student Counseling Services Director, Janet Spoltore, Ph.D., ABPP.

• Authorization to Disclose/Obtain Protected Health Information (PDF)

Forms are saved as PDF documents. PDF documents are viewable on both Macintosh and PC platforms, but require the Adobe Acrobat Reader.

Download Adobe Acrobat Reader