Initial Request to Connect If you feel that you need immediate assistance, please contact Colorado Crisis Services at 1-844-493-8255 or text TALK to 38255. Outside of Colorado, call or text 988. For life threatening emergencies, please dial 911. *Required FieldName* First Last Preferred Name/PronounsMines Email Address Required (others go to junk mail)* Enter Email Confirm Email CWID*Phone #*Current City* Golden Current State* Colorado Please choose from the service options below* Initial 15 minute Phone Consultation with a CounselorReferral Assistance to Off-Campus CounselorsInitial 15 minute Phone Consultation with a Wellness CoachChoose this option to schedule an appointment with a counselor for a 15 minute phone consultation to determine next steps which may include therapy sessions, groups, workshops and other resources or referrals. Reason for Request*Please list a brief reason for your request so that we can connect you with the appropriate counselor or resource.Availability*Please list times that you are available M-F 8:30am-4:30pm MST to receive a 15 minute phone consult from a Mines counselor. We will schedule you in the next available appointment that matches your request and respond by email with your appointment date and time. Choose this option if you would like to receive a personalized referral list to off-campus counselors.*PLEASE NOTE: If you like to speak with a Mines counselor for guidance, select "initial phone consultation" from the drop down above. Health Insurance Coverage* United Healthcare/SHIP Anthem BCBS Aetna Cigna Medicaid Tricare United Healthcare Receive & Review Options:* Receive personalized list & assistance by email Receive personalized list by email & meet with case manager (please list availability below) Additional Information:*Please provide any specifics important to you in your search for a counselor (i.e. location, specialties, language, gender, etc.)Choose this option if you would like to receive a personalized consultation with a Wellness Coach. What is Wellness Coaching? Wellness coaching is client-centered, nondirective approach to improving your overall well-being. You'll work with a coach to define what "success" means for you, identify your unique strengths, and build a custom plan to help you achieve your goals. This plan might include a variety of lifestyle changes, such as improving your time management and prioritization skills, developing new strategies for healthy eating, exercise, or stress management. By working with a wellness coach, you can create a realistic path to success and build the skills you need to sustain it. Wellness coaching is not therapy or medical treatment. If you would rather speak with a Mines counselor for guidance, select "initial phone consultation" from the drop down above. AvailabilityTo start, you'll have a quick 15-minute phone call to discuss your wellness goals and see if coaching is the right fit for you. Please list times that you are available M-F 9:00am-4:00 pm MST. We will schedule you in the next available appointment that matches your request and respond by email with your appointment date and time.Please include some details about the specific wellness area you’d like to focus on. (Please note if you are in CSM 202)CAPTCHA