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Stanford MMHI: Utilization of Services
Please fill out this form if you are unable to schedule an appointment because of one of the following reasons:
Lack of appointment availability
Your status/affiliation with Stanford
You are on a leave of absence
This is not an anonymous form but will only be shared with Maristan administration in order to encourage Stanford to expand these services to a broader population.
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Email
*
Your email
Please provide your full name:
*
Your answer
Current status at Stanford University:
*
Undergraduate Student
Graduate Student
Professional (Medical, Law, Business, etc.) Student
Post-Doctoral
Undergraduate/Graduate student on a leave of absence
Other:
Please select the option that best explains your current standing with the MMHI Program:
*
I am unable to seek services through the program as my current status is not covered under the current program
I have not been able to book an upcoming appointment due to no availability
I have been able to book an appointment but it is a few weeks out and I feel I need to be seen sooner
Other:
If you were able to book an appointment, please indicate how far out you had to book in order to be seen.
A few days
One week
Two Weeks
Three Weeks
Four Weeks
Five Weeks +
Clear selection
Please leave any additional comments you would like Maristan, the Markaz and Stanford to know/consider regarding your inability to utilize these services at your convenience.
Your answer
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