Instructions - Please fill out this form below and click submit. You will be contacted for an appointment within 1 business day. This form will be kept confidential. Please call Amy Solman, Director: Health & Wellness Center, at 724-847-4081 or email email@example.com if you have questions.
If this is an emergency or you are in a crisis, do not fill out this form. For immediate assistance, please contact your Resident Assistant, Resident Director or the local Beaver County crisis hotline at 724-775-5208 for aid during non-business hours.