Peer Support/Coffee Chat Request Form :)

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Hi! Thank you for clicking! And for having the courage to reach out :) Please fill out the form below and you will receive an email from a Peer Responder within 24 hours about setting up your chat session!

For more information about Peer for You & Peer Responders, you can see our website at peerforyou.org

Name:

NetID: *

What would you like to talk about? (it's okay if you don't exactly know!)—check all that apply:

Stressed about school/academics

Overwhelmed by the different parts of my campus life

Adjusting to campus life due to COVID-19

Trouble making friends/I don't feel like I have friends

Loneliness

Homesickness

Dealing with grief/loss

Rush

Dealing with identity - LGBTQ

Dealing with identity - student of color

Body image/disordered eating

Relationships

Other:

Do you know who you would like to talk to? Check out responder bios at https://peerforyou.org/responders/ (if you don't have a preference at the moment, we can pair you up with a responder who relates to your concerns)

Would you prefer to talk to a person of a certain identity (gender, person of color, etc.)?

Would you prefer to talk to someone in-person or through Zoom?

In-person

Zoom

Phone Call

Text

Other:

Clear selection

Any other questions/comments/concerns?

Submit

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