Appointment Cancellation Form

NC State University Counseling Center Appointment Cancellation Form

If you need to cancel your appointment that is scheduled at the Counseling Center, you can submit this form online or call the Counseling Center between the hours of 8:00 am - 5:00 pm, Monday through Friday. Please note, that if you fail to cancel or reschedule an appointment at least 24 hours in advance, a $25.00 charge will be added to your SHS Account.

Please provide all of the following information:

First Name

Last Name

Student ID Number

Do you wish to cancel your scheduled appointment?

Yes

No

What is the date of your appointment? (mm/dd/yy)

What was the time of your appointment? (hh:mm am/pm)

Please provide the reason for canceling your appointment