Counseling & Psychological Services

Request for Interview

Please note the following guidelines prior to making your request:

• Please make sure we receive your request at least 3 weeks in advance.
• Please provide 1 or 2 alternate dates.
• if an interview is scheduled, please notify us as soon as possible if the interview needs to be canceled or postponed. Contact us at (619) 594-5220.

Please provide the following information
Date and time of interview
a. Alternate date/time
b. Alternate date/time
Type of Interview	In-person Phone E-mail questions All of the above are acceptable (increases the likelihood your request will be fulfilled in a timely manner)
Topic of interview
Purpose of interview	Class Paper - course name Article (i.e.: Daily Aztec, paper for Communications course) Professional Interest Other - please describe
Special instructions
Contact Information
Name
Alternate contact person
Affiliation
Office phone
Cell phone
Home phone
E-mail