Student Counselling Services Registration Form

​Welcome to Student Counselling Services! You have come to a supportive and confidential environment. Together you and your counsellor will develop a plan that will help you to move forward.

Personal information collected during the intake process will be used by Student Counselling Services for service delivery and planning purposes as per the Red River College Polytechnic Act and in compliance with The Freedom of Information and Protection of Privacy Act and the Personal Health Information Act. For more information, visit Absent an exception allowed by law, application and student information cannot be provided to anyone other than the student unless the student has provided written consent to Student Counselling Services.

Student Counselling Services has received your registration form. Someone from our office will be in touch with you within 3 business days to schedule an appointment.

If you indicated you are in crisis, we will contact you within 1 business day. If you are in crisis, please see Community Crisis Resources. Thank you.

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Personal information

Your Preferred Service Delivery Method? (Check all that apply)

Emergency contact information

Program Information

Counselling Information

What would you like to meet with a counsellor about? (Check all that apply) It is not uncommon for personal concerns and stressors to impact a student's college experience, academic focus, achievement and overall mental health. Counsellors at RRC welcome you to explore ways of coping, increase your resillency and work through difficult issues.
If you are having difficulty completing this form, please contact


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