Fill out the information below and someone will contact you to book an appointment with one of our counsellors.

Indigenous student requesting an Indigenous counsellor*
Please use this format: xxx-xxx-xxxx
Which campus are you from?

This information is collected for the purpose of contacting you to arrange an appointment and will be kept on file with Counselling Services. For further information about privacy at Saskatchewan Polytechnic, see our Privacy Statement online at

Counselling Services Informed Consent form

To learn more about your rights as a counselling client, please read our Counselling Services Informed Consent form. We care about your rights, privacy and safety and encourage you to read the form before your first session.

What to expect

  • Saskatchewan Polytechnic Counselling Services offers current students a safe environment to discuss your concerns, help you understand your strengths, learn new skills, and empower you to set goals and make changes.
  • Counselling sessions are free and offered through phone, Zoom video and in person.
  • Your counsellor will invite you to talk about the benefits and costs of making the changes you are considering and then support you in working on your goals.
  • Counselling is most helpful when you work together with your counsellor.

Rights and responsibilities

  • It is important to know that you have many rights as a client including the right to say “pass” or “no,” and to stop counselling at any time.
  • You have the right to change your counsellor at Sask Polytech.
  • For counselling options outside of Sask Polytech, your counsellor will make efforts to support you with referrals and/or resources.
  • For phone or Zoom appointments, it is the student’s responsibility to secure adequate technology. You will need a quiet, private space free from distraction/intrusion, with sufficient lighting and in a safe fixed location.
  • Counsellors cannot accept any personal contact or social media invites.
  • Ask your counsellor if you have any further questions about your rights as a student accessing counselling.

Counselling appointments

  • You and your counsellor will discuss a plan to deal with potential problems that may arise during a technology assisted counselling session.
  • Counsellors will take steps to protect your privacy. Choosing a private space for your phone or Zoom sessions is your responsibility.
  • Counselling sessions shall not be recorded in any way.

Electronic or technology-assisted communication

  • Sask Polytech uses reasonable means to protect the security and confidentiality of information sent and received using electronic communications. There are potential risks of using technology assisted communication.
  • Privacy and security of electronic communication cannot be guaranteed. Electronic communications and files might be forwarded, intercepted, circulated, stored or changed without the knowledge or permission of Counselling Services or the student. This may result in sensitive information being unsecured.
  • Electronic communications are subject to disruptions beyond our control and may prevent service provision.

Your File

  • Your name, address and contact information are shared with office coordinators for appointment bookings and data collection purposes only.
  • Your counselling file, which is stored separately from your academic file, contains brief notes summarizing sessions. Files are securely stored for 7 years.
  • You have the right to request information from your file and are encouraged to ask your counsellor any questions.
  • To maintain best practice, consultation with other counselling staff or the manager may take place.
  • Only the manager of counselling is allowed to access your file on an as needed basis.
  • If a counselling staff member is working on higher credentials, and receiving outside supervision, a separate consent form will be provided at the first session.


  • You have many rights to privacy and confidentiality. Any information you have shared with your counsellor will remain confidential as we are bound by a code of ethics and professional guidelines.
  • Your counsellor will not approach you in public to protect privacy; however, you are welcome to acknowledge them if you would like.
  • If we need to obtain or share information with other professionals, we will request your consent in writing. You have the right to refuse consent and your wishes will be respected.
  • You have the right to withdraw consent to release at any time.
  • There are times when private information would be released without signed consent. These times include:There is reason to believe that you are at imminent danger of harming yourself or others.
  • You share, or your counsellor believes, that another person (including children and vulnerable persons) is at risk for serious harm.
  • Your file is subpoenaed or requested by court of law.
  • When private information needs to be released counsellors will only share relevant information to ensure safety.


  • In an emergency and/or if your counsellor is concerned for your safety, and unable to reach you, your emergency contact may be notified. Alternatively, necessary authorities or emergency services may be called.
  • Your chosen emergency contact is ___________________________.

By signing or verbally consenting to the above with your counsellor, you confirm you understand the information as provided and would like to proceed.