Schedule an Appointment

Please use this form to schedule your first BASICS or Screening and Brief Intervention appointment.

OSAPSS staff will schedule your session using the schedule that you provide. You are responsible for having an appointment scheduled prior to your deadline. If you do not attend a scheduled appointment, you may be fined for failure to comply.

Please provide us with your current schedule this semester. Please be aware that it may take up to three weeks to receive an appointment. We are sorry for the inconvenience, but we ask that you please be patient with us.

First Name	Last Name


Birthdate (MM,DD,YYYY)


Class Year	Fordham ID Number
	- -

Type of Referral


Cell Phone Number	Preferred Email Address (one that you check regularly)


Who Referred You (i.e. name of the Residential Life/Student Affairs administrator)


Weekly Schedule of hours you are in class (Including Weekends)


Additional Information - (Questions, Concerns, Other Obligations)

Our appointments occur during regular business hours; Monday-Friday 9am-5pm and limited hours durring saturday and sunday.

For a description of BASICS and the Screening and Brief Intervention program, a list of Frequently Asked Questions, staff member bios, and information regarding other services provided by OSAPSS, please visit our website: www.fordham.edu/osapss or contact us directly at osapss@fordham.edu.