HERC Consultation Request Form

HERC Consultation Request Form

One-on-one consultations at the HERC

EIU students have the opportunity to meet with one of our staff on a variety of health related topics. Many of the sessions are strictly educational and FREE. Topics include the following:

Nutritional Analysis
Sleep Hygiene
Mindfulness Practices
Resiliency
Boundary Setting
Sexual Health
Alcohol & Other Drug
Coping with Stress

Please note: to make an appointment with a Licensed Clinical Counselor you must contact the Counseling Clinic at 217-581-3413. The HERC and staff are not licensed and sessions should not be considered counseling.

Name Name * First Last
Phone Phone - ### - ### ####
Email
What is the best way to contact you? *

What is the best way to contact you? Phone Email
Please select the topic(s) you would like to focus on in your one-on-one consultation. *

Please select the topic(s) you would like to focus on in your one-on-one consultation. Nutritional Analysis Sleep Resiliency Mindfulness Practices Sexual Health Alcohol and Other Drug Coping with Stress Boundary Setting
Please identify a possible date you would like to meet. We will do the best to accommodate, if we are not available during this day we will work with you to schedule a day and time. Please identify a possible date you would like to meet. We will do the best to accommodate, if we are not available during this day we will work with you to schedule a day and time. / MM / DD YYYY