Referral for Counseling Services Form

Notice of privacy practices: Texas State University Professional Counseling Program faculty, staff, and graduate instructional assistants will view this information.  All of these individuals are ethically required to maintain your confidentiality.

If you would prefer to contact the clinic yourself or get more information you can call 512-245-8349 for the San Marcos Clinic or 512-716-4250 for the Round Rock Clinic.  If your situation is an emergency, please do not complete this form.  Call 911 or go to the nearest emergency room.

For individual counseling, complete an online referral form for EACH client.

Client Information

Referral Information