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Faculty & Staff Assistance Program
Division of Strategic Resources and Support
Faculty & Staff Assistance Program
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Contact FSAP
First name
*
Last name
*
Preferred name
Pronouns
Pronunciation
Email
*
May be work or personal email.
Confirm email
*
Phone number
*
Is it okay to leave a detailed message at this phone number?
*
Yes
No
Preferred method of contact
*
- Select -
Phone
Email
Note: Phone calls may appear as coming from a “Blocked” number.
Are you an employee at the University of Colorado Boulder?
*
Yes
No
Department
Job title
Is this your first request to speak to FSAP or are you a returning client?
*
Yes, I would like an intake session.
No, I am a returning client.
I would like to:
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Schedule an appointment with a counselor
Talk with a counselor on the phone about outside referrals
Other
Please tell us what prompted you to contact FSAP and/or if you have therapist preferences. We will meet requests based on availability.
*
Would you prefer your intake session to be done via teletherapy or in-person?
*
Teletherapy
In Person
All clinicians are trained to work with diverse clients. Do you want the first available?
*
Yes
No, I have a preferred counselor.
Please note: while efforts will be made to match you to your preferred counselor, it’s possible you may be assigned to another counselor due to availability.
Preferred counselors
Carla Eugene
Esther Horowitz
Meredith Lopez
Paulette Erickson England
Stanley Ly
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