SCC - Outreach Request Form

To ensure our availability, we ask that this form be completed at least 2 weeks before desired date. Request made with less than 2 weeks’ notice may not be able to be accommodated. Submitted request will be reviewed by the SCC staff who will then contact you by phone or e-mail to confirm your request. If you do not hear from us within 48 hrs, you may reach out to us at 301.687.4234. This form is not for scheduling counseling appointments, if you would like an appointment please call our office at 301.687.4234.

Your Name

Department/Organization

Email Address

Phone

Perspective Audiences

Other Audiences

Type of Request

Tabling – Informal way of greeting, engaging, and providing information about SCC and our services.Presentation – Presenting information about a specific Mental Health topic to an audience.Round Table or Reflective Discussion – A meeting to discuss a Mental Health topic with equal participation from the audience.ORIE Presentation - This presentation has been designed specifically for ORIE Classes. We review information about SCC and the services that we provide in our office. Additionally, we discuss topics related to Mental health and Self-Care. Students will leave the session with tools to utilize for managing stress and a better ability to recognize signs that they may need support with their mental health.

Name of Event

Topic Requested