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College Health Center to University Counseling Referral Form
About this free form template

Streamline Student Mental Health Referrals with Paperform

College health centers play a crucial role in identifying students who need specialized mental health support. This College Health Center to University Counseling Referral Form template helps healthcare providers create seamless, compliant referrals that ensure students receive the right level of care at the right time.

Built for Higher Education Health Services

Whether you're a campus health center physician, nurse practitioner, or mental health screener, this form template captures everything university counseling centers need to triage and match students with appropriate providers—mental health screening scores, academic impact, crisis history, and recommended therapy modalities.

The form uses conditional logic to adapt based on screening results and crisis indicators, ensuring that urgent cases are flagged immediately while routine referrals include comprehensive background information. This means faster intake, better therapeutic matches, and continuity of care between your health center and counseling services.

Why Paperform for Student Referrals?

Unlike generic healthcare forms or clunky PDF workflows, Paperform gives you:

  • SOC 2 Type II compliance to protect sensitive student health information
  • Conditional logic that surfaces crisis protocols only when needed
  • Professional, on-brand forms that reflect your institution's visual identity
  • Instant notifications to counseling center staff when urgent referrals come through
  • Integrations with your student information system, Google Workspace, or case management tools

You can embed this form directly into your EHR workflow, share it as a secure link between providers, or use it as part of a broader student wellness intake process. With Paperform's calculation fields, you can even auto-score screening tools and route referrals based on severity.

Automate Follow-Up with Stepper

After a referral is submitted, use Stepper to automatically notify the counseling center, create a case file, schedule follow-up checks, and send confirmation emails to referring providers—all without manual data entry. This keeps everyone accountable and ensures no student falls through the cracks during transitions of care.

Trusted by Higher Education Institutions

Paperform is used by universities, colleges, and student health services worldwide to manage everything from patient intake and appointment scheduling to wellness surveys and referral coordination. Start with this template and customize it to match your institution's screening tools, protocols, and branding in minutes.

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