ADULT APPLICATION

You may obtain an adult application from the clinic, located in the new Psychology Building at 1107 W. Call Street, Suite C-122, or by downloading one from this site.

There are three parts to the adult application for services:

One part is the application itself, which can be obtained from clicking on the following link: adultapp.pdf. The second part is the “FSU Psychology Clinic Income Information”. This information asks about your income and dependents and requires the signature of a witness (and/or notary public). Although you need to complete this form, please note that you DO NOT have to get a witness or a notary public. Office staff will handle witnessing the application for you. The FSU Psychology Clinic Income Information form can be obtained by clicking on the following link: fees.pdf. The third part is the Consent for Taping, Observation, and Research Participation form. For more information about this form, please click on the active link. The Consent for Taping, Observation, and Research Participation form can be obtained by clicking on the following link: obsrvconsent.pdf.

If you decide to apply to our clinic for services, there is a $25 fee for the application process. If you are coming for couples or family therapy, the fee is $35. For more information on the application process see application process.