Wellness Coaching Refer a Student

Please use this form to refer a student to Wellness Coaching. A RecWell Wellness Coach will follow up with the student.

* denotes a required field

Referring Person's Name *

Referring Person's Email *

Referring Person's Email (Confirmation) *

Referring GVSU Department (if applicable)

Student's Name *

Student's Preferred Pronouns (if known)

Student's Email Address *
Please enter a GVSU email address ending in @gvsu.edu or @mail.gvsu.edu.

Student's Email Address (Confirmation) *

Reason for Referral *

Any other pertinent information?

Human Verification *

Page last modified August 18, 2023