Habif Health and Wellness Center and Center for Counseling and Psychological Services Outreach Form

To request an outreach presentation, please fill out the form below. Please respond to the questions with as much information as possible.

  • Please give a minimum of two weeks’ notice
  • Our presentations are generally 1-2 hours
  • We will confirm the program by email
Habif: Outreach Request Form
Your Role:
Topic Requested:
Anticipated Time:
Length of Outreach Program Desired:
Who is the intended audience for this Outreach Presentation?
Technology Available at Location of Outreach Presentation: