Forms

Forms for students

Consent for treatment

Before receiving support from CAPS, all students must review and complete the Consent for Treatment form. This form outlines your rights, the scope of services, and important information about confidentiality.

Release of information

If you need to authorize CAPS to release or request your confidential mental health information, please complete the Release of Information form. This ensures your records are handled according to your wishes and HIPAA guidelines.

Privacy notice

CAPS is committed to protecting your personal health information. This Privacy Notice explains how your medical and psychological data may be used or disclosed, your rights regarding that information, and how to request access or file a complaint.

Couples intake

If you and your partner are seeking support through CAPS, please complete the Information Form for Spouses/Partners. This form helps our clinicians understand your needs and prepare for your initial appointment.

Forms for faculty & staff

Mandated evaluation referral

This form is required to initiate a mandated evaluation through CAPS. It should be completed by the referring MUSC faculty or staff member and submitted prior to scheduling the student's appointment.

Required evaluation release

If you’ve been referred for a required mental health evaluation, you must complete this authorization form to allow MUSC Counseling and Psychological Services (CAPS) to share necessary information with designated university officials. Completing this form ensures the evaluation process can move forward in accordance with privacy regulations.