Cal Drop In Counseling Appointment Form

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Cal Drop In Counseling Appointment Form

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Thank you for your interest in drop-in counseling with Loyal Blue Counseling, a solution-focused practice run by Cal alum Lindsey Antin (Go Bears!) We know what it’s like to need a little advice from time to time.

How it Works

While we have regular hours set up once a month with several sororities, any Cal student can fill out this form to set up up a call.

You can talk about ANYTHING!

Common topics are feelings of stress, depression, anxiety, food or sleep issues, family and social life, relationships…even careers in psychology and beyond. We look forward to getting to know you.

Who Can I Talk To?

Lindsey, Jessica, Kennedy, and Tara currently do our free drop-in counseling appointments. (We also offer full appointments for paying clients at our practice; read about us here!

Tara, AMFT

Name *

First

Last

What year in school are you? *

First Year
Second Year
Third Year
Fourth Year
Grad Student
Other

Phone *

We will text you at this number to set up a call.

Email *

In case we need to send you some notes from our talk, or provide helpful resources or other info.

In Person Or Phone Call?

In-person, at Loyal Blue's next house visit (usually 1st or 2nd Monday of the month)
Earliest available

Which organization are you involved in (if any)?

Alpha Phi
Pi Beta Phi
Kappa Kappa Gamma
Adulting DeCal
Student Athlete
Other

Have you ever had any type of counseling before? Include if you’ve participated in drop in!

Tell us a little bit about what’s going on with you right now, and what you’d like to talk about. *

Are you having thoughts of self-harm or suicide? *

Yes
No

If yes, you must complete the next question before submitting.

Please provide two names and numbers we could contact for your support and safety (only if necessary and with your permission):

Help is on the way!

Yes please

...I'd like to receive Loyal Blue's email newsletter which contains skills, info on what’s working in counseling, and tips to lead a happier and healthier life. (We won't share your information.)

We are not, nor are we holding ourselves out to be a doctor/physician, nurse, physician’s assistant, or any other medical professional. Drop-in counseling is not a substitute for medical and mental health care provider services. View our full Medical Disclaimer.

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info@loyalbluecounseling.com

call or text:
510.842.7097

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