Client Registration

  • This paperwork is not intended for emergencies or for those that are in crisis. For crisis care, please contact our office at 501-450-3138 during business hours. For after-hours, contact the UCA PD at 501-450-3111. For emergencies contact 911 or go to your nearest emergency room.
  • Please note that we cannot provide virtual (online) counseling outside of the state of Arkansas.
  • This paperwork is for those wanting to set up ongoing sessions with a therapist. It must be completed by the individual that is seeking counseling. 
  • If you are a UCA Faculty/Staff member and not currently a student, counseling is available through the Employee Assistance Program. https://uca.edu/bewell/eap/

NOTE: WE DO NOT HAVE ONLINE APPOINTMENT SCHEDULING. You will be contacted by a counselor to schedule your appointment. If you are currently seeing one of our counselors, please do not fill out the forms again. Please contact our office as soon as possible if you can not keep your appointed session at 501.450.3138.
Registration for Fall 2024 will close beginning November 25, and will re-open January 2, 2025.  Counselors will be available for emergency situations at our offices daily if needed until we break for the holidays.  A counselor will be on call during the holidays and you may call the UCA PD at 501.450.3111 if you have a mental health emergency.