Student Health & Counseling Student Groups

P.O. Box 755580, 1007 N. Chandalar Drive | Fairbanks, AK 99775-5580 P: 907-474-7043 F: 888-837-2146 | www.uaf.edu/chc
Student Health & Counseling Student Groups FALL 2026

Registration Form
Name

First NameLast Name
UA#
Date of Birth
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Are you a current UAF student?
Please select the group you would like to attend:
Are you currently receiving individual counseling services?
Have you ever participated in a psychotherapy group before?
What are you hoping to get out of the group experience?
UAF is an affirmative action/equal opportunity employer, educational institution and provider and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination/.
Should be Empty:

Student Health & Counseling Student Groups FALL 2026