Student Telehealth Intake for Mental Health & Medication Care

Our Student Telehealth Intake is designed for students seeking mental health support, psychiatric evaluation, or ongoing medication management through secure virtual care. This intake form helps our licensed clinical team understand your needs in advance so we can guide you toward appropriate next steps and continuity of care.

Students can complete this intake independently and confidentially, with services available statewide in Florida.

Who Should Complete the Student Intake Form

This form is intended for students who:

  • Are seeking mental health or psychiatric care through telehealth

  • Need medication evaluation or ongoing medication management

  • Want support that fits a student schedule and lifestyle

  • Are managing care independently as an adult student

Completing this intake allows our providers to review relevant information before scheduling or follow-up.

What the Student Intake Helps Us Do

  • By completing the Student Intake Form, you help our team:

    • Assess clinical needs prior to an appointment

    • Determine whether medication management or additional support may be appropriate

    • Coordinate care efficiently and avoid unnecessary delays

    All information submitted is reviewed by licensed professionals and used solely for care coordination.

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