BetterMynd Referral Form

SUNY Fredonia is partnered with BetterMynd, an online therapy platform, to offer students access to free teletherapy sessions from a diverse network of licensed mental health counselors.

These 50-minute live video sessions are private and confidential and can take place from the convenience of your laptop, smartphone, or tablet. Teletherapy sessions are available during the day, at night, and on weekends.  In addition to teletherapy sessions, BetterMynd also offers free group workshops.

Please complete the following form. Once we receive your completed form we will arrange a phone consultation with a member of the Counseling Center staff, 716-673-3424. During the phone consultation we will conduct a brief assessment, provide an overview of BetterMynd, and help finalize your registration process.

Sign in to Google to save your progress. Learn more
Name (first & last)
 *
F number
 *
phone number
 *
email address
 *
Address (Residence Hall name/room number or off-campus address)
 *
Please select ALL of the days/times you would be available for a 15 - 20 minute phone consultation: 
Mondays
Tuesdays
Wednesdays
Thursdays
9:00 - 9:30am
9:30 - 10:00am
10:00 - 10:30am
10:30 - 11:00am
1:00 - 1:30pm
1:30 - 2:00pm
2:00 - 2:30pm
2:30 - 3:00pm
3:00 - 3:30pm
3:30 - 4:00pm
4:00 - 4:30pm
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of SUNY Fredonia. Report Abuse
Google Forms