Marquette University
Counseling Center
Please enter your personal information below.
First Name:
*
Middle Name:
Last Name:
*
Preferred Name Name:
Preferred Pronouns:
Date of birth
*
Student ID:
*
Cell Phone Phone:
*
OK to leave message?
*
Yes
No
Okay to text appointment reminders?
Use Cell Phone
Do not send text messages
Campus Address
OK to contact at Campus address?
Yes
No
Previous
Next
Please wait while your browser submits your request…