Forms & Policies

Important Forms

New College of Florida Immunization Form
Release of Information Form for Counseling & Wellness Center


To schedule an appointment please call 941-487-4254 & press option 1 or stop in during regular working hours, 8 a.m. to noon and 1-5 p.m. You may leave a message on our voicemail after business hours. We will get back with you at the earliest opportunity. Individual and couples therapy appointments are generally for 45-50 minutes and are typically scheduled once per week at a time you and your therapist agree upon. If you are 20 minutes late for an appointment, you will not be seen that day, but are welcome to reschedule.

If you cannot make a scheduled appointment, it is your responsibility to call 941-487-4254 to cancel. If you forget an appointment, call as soon as possible to reschedule. If you miss your appointment and do not call to reschedule, there is no guarantee your therapist will have another available appointment time. If this occurs, you may choose to be placed on the waitlist and reassigned; you may use our emergency counseling services in the meantime.

When appropriate, referral to a psychiatrist is made through one of the staff therapists.


If we determine that your treatment needs require resources or competencies beyond our scope of practice, (e.g., medically, level of severity, pharmacologically, legally, etc.) we will assist with a referral to those resources.

Students presenting such conditions will be referred to appropriate resources in the community and are responsible for paying the costs incurred for services and treatment provided through outside agencies.

Unsafe Behavior and Denial of Services

We do not intervene with students who are intoxicated or under the influence of drugs. Individuals who are under the influence may need medical attention or to be kept safe in a hospital or other secure environment. Therefore, a psychological intervention would serve little purpose. Further, if you are experiencing symptoms of a compromised immune system, such as the flu or a cold, please call and allow us to reschedule your appointment.

The Counseling and Wellness Center reserves the right to deny further services to individuals whose concerns are beyond the capacity of this office to effectively treat as well as to any individual that abuses or misuses services in any manner (e.g., noncompliance with treatment, frequent missed appointments, etc). If this should become necessary, other local treatment options and possible referrals would be discussed.

Emergency Leave of Absence

Currently enrolled New College students have the ability to take an emergency leave of absence in the event of an unanticipated emergency or crisis that impairs the student’s ability to function academically. Click here to read the College’s policy and procedure regarding taking an emergency leave.

Medical provider form
Mental health provider form

Limits of Confidentiality

Information shared by you in assessment and counseling sessions will be treated with the strictest confidentiality and in most instances will not be disclosed to anyone without your written permission. A copy of our release of information form is available from the Center staff. There are situations that require only that you provide written, advanced consent, such as the following:

  • We train advanced graduate students from the mental health profession and psychologists who are not yet licensed in Florida. Licensed psychologists provide supervision, which may include discussion of your treatment and clinical record.
  • Because of our training mission and quality assurance, your therapist may ask your permission to record sessions for confidential supervisory and training purposes. Recordings are placed on a secure external hard drive, are not connected to any online network, and are kept in a locked cabinet and erased at the end of your treatment.
  • Your therapist may occasionally seek consultation with other Counseling and Wellness Center staff members about a case. In addition, administrative staff will need access to protected information for such purposes as scheduling and quality assurance. All staff members have been given training about protecting your privacy and have agreed not to release any information outside the Counseling and Wellness Center without the permission of a professional staff member.

There are some situations where we are permitted or required to disclose information either with or without your consent:

  • If you are involved in a court proceeding and a request is made for information concerning your treatment, we cannot provide such information without your written authorization, or a court order. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order your therapist to disclose information.
  • If a government agency is requesting the information for health oversight activities or national security.
  • If a client files a complaint or a lawsuit against a therapist, we may disclose relevant information regarding the client in order to defend the therapist.
  • If your therapist has reason to believe that a child or a vulnerable adult is being neglected or abused, the law requires that the situation be reported to the appropriate state agency.
  • If the therapist believes you present clear and substantial danger of harm to yourself or others, the therapist will take protective actions. These may include contacting family members, seeking hospitalization for you, notifying any potential victim(s) and notifying law enforcement.

This summary is designed to provide an overview of confidentiality and its limits, therefore, it is important that you read our Notice of Privacy Practices for more detailed explanations, and discuss with your therapist any questions or concerns.

Lastly, please note that email is not a secure form of communication and is not recommended as a primary method of contacting your therapist for any treatment related concerns. Unless your therapist and you agree otherwise, please call to leave a message and talk with the Center staff if you need to cancel or reschedule an appointment. Note that any communication you have with a therapist outside of a regular appointment session may be documented in your record at the Center.


If you are under 18 years of age, please be aware that the law may provide your parents or legal guardian the right to examine your treatment records. Before giving parents or legal guardians any information we will discuss the matter with you, if possible, and do our best to handle any objections you may have with what we are prepared to discuss.

Professional Records

The laws and standards of our profession require that we keep Protected Health Information (PHI) about you in your clinical record. Your clinical record includes information about your reasons for seeking therapy, a description of the way in which your concerns affects your life, your diagnosis, the goals for treatment, your progress toward those goals, your medical and social history, your treatment history, results of clinical assessments (including raw data), any past treatment records, and copies of any reports that have been received or sent to anyone.

Personal information that you share with your therapist may be entered into your clinical record in written form. However, efforts are generally made to avoid entry of information that may be especially sensitive or embarrassing. Your clinical records are not part of academic records and clinical records are maintained for seven years. For additional information, please refer to the the Notice of Privacy Practices.

Research and Quality Assurance

After your treatment has been completed, you may receive a brief questionnaire from the Center. Information for an annual report of services is routinely compiled and reported as group averages with no individually identifying information. This is used for program planning, service evaluation, and to assess service needs.

Immunization Requirement

The state of Florida requires all students under the age of 40, whether degree or non-degree, full-time or part-time, to present documented proof of immunity to Rubella. All students born after 1956 must also submit proof of immunity to Measles. Submit documentation prior to registration to Student Health Services, Counseling & Wellness Center.

Final Note

Although it is not possible to guarantee outcomes, The Counseling and Wellness Center is committed to providing quality services. If you ever have any concerns about your experience, we encourage you to speak with your therapist about this. If the difficulty cannot be resolved by working with your therapist, you may address your concerns to the Program Director of the Counseling and Wellness Center, Anne E. Fisher, Ph.D. Copies of ethics codes, relevant laws, and administrative rules of the professional licensing boards are available upon request.