Missed Appointment Appeal Form

Students who have missed a scheduled appointment at the Student Health and Counseling Center are assessed a fee. Students may appeal that fee using the following form.

Student ID number, 8-digits and most start with 3

Enter phone number with area code.

Please state the reason(s) you feel your missed appointment fee should be reversed.

If your appeal is granted, you will be notified via your email account and a credit will be sent to your UAA account.