This form should be used for any NON-CLINICAL requests or inquiries you and your group have of Wolverine Wellness, CAPS, or UHS - from asking for a consultation, to having us lead a workshop, to requesting personal well-being items. Please note the following guidelines related to this form:
* Please submit the form at least 3 weeks from your preferred date, otherwise we may not be able to fulfill your request.
* Requests are reviewed based on the order they come in and may take up to a week (or more during breaks) to be reviewed. Due to the high number of requests we receive, please allow us at least a week to get back to you.
* If for any reason we cannot fulfill your request, we will provide suggestions about alternate tools and resources to meet your needs.

Contact Info

We'll contact you via your UMICH address. If you prefer we use a different address, please enter that here.

Request Info

Are you submitting a request/inquiry for a group or for yourself?
Are you submitting a request/inquiry for a group or for yourself?
Student organization, residence hall, department, etc.
Who is the main target audience for this request?
You can choose more than one.
Who is the main target audience for this request?
For more information on the types of requests, please visit our Wolverine Wellness website. There you can find a description of the services we offer, which can help you in selecting the right request for you.
This helps us determine who from our team would be best to meet with you.
Format the options as “mm/dd: time range” (e.g. 01/01: 12-1pm).
Would you prefer this consultation to be in-person or over zoom?
Would you prefer this consultation to be in-person or over zoom?
Include in your description if this is part of a larger effort or if we will be a stand alone table.
If you are flexible on the date or time, please list a preferred option.
Is this a pre-set time that should not be moved or are you flexible on the time?
You may be filling this form out at various stages of the event planning process so it is understandable to pick either option.
Is this a pre-set time that should not be moved or are you flexible on the time?
Please list the whole name of a building rather than an acronym.
Is there a specific topic would you like us to focus on while tabling?
Is there a specific topic would you like us to focus on while tabling?
Which topic would you like us to give a workshop on?
Which topic would you like us to give a workshop on?
Please include information on the purpose of this event.
Note: Workshops range from 45-90 minutes. If you have an event that spans longer than this, please only list the time frame in which you will need Wolverine Wellness there for the workshop.
If you are flexible on the date or time, please list a preferred option.
Is this a pre-set time that should not be moved or are you flexible on the time?
You may be filling this form out at various stages of the event planning process so it is understandable to pick either option.
Is this a pre-set time that should not be moved or are you flexible on the time?
Will the workshop be in-person or virtual?
Will the workshop be in-person or virtual?
Please list the whole name of a building rather than an acronym.
Will attendance be collected at the event?
We preference requests from groups that require attendance, or where students are incentivized to attend. To protect the time of all involved parties, we ask for a group minimum of at least 15 individuals. We may ask that you provide us an attendance list following the event.
Will attendance be collected at the event?
Include: Sessions Track Link, Class Roster, etc
Enter approximate number.
Which offering are you interested in?
For more information on these offerings, please visit our Well-being Academy website -- https://uhs.umich.edu/wellbeing-academy Please note that the Introduction to Motivational Interviewing 20 hour training is offered once in the Fall and once in the Winter semesters. Registration for this training will be available on sessions.
Fall 2023: https://sessions.studentlife.umich.edu/track/ev...
Winter 2024: https://sessions.studentlife.umich.edu/track/ev...
Which offering are you interested in?
Would this training be just for you or a team?
Would this training be just for you or a team?
When would you like to have this training?
We try to combine trainings whenever possible. If another group is hoping to have the training around the same time as you/your group we will coordinate to find one training time which works for all parties.
When would you like to have this training?
Which offering are you interested in?
These options are training programs and academic partnerships available to instructors to help incorporate well-being into their work with students. Select the topic which best aligns with what you hope to accomplish.
For more information on these offerings, please visit our Well-being Academy website https://uhs.umich.edu/wellbeing-academy
Which offering are you interested in?
Would this training be just for you or a team?
Would this training be just for you or a team?
This is a numeric only option
Format the options as “mm/dd: time range” (e.g. 01/01: 12-1pm).
Please include information on the other departments who will be represented on the panel.
If you are flexible on the date or time, please list a preferred option.
Is this a pre-set time that should not be moved or are you flexible on the time?
You may be filling this form out at various stages of the event planning process so it is understandable to pick either option.
Is this a pre-set time that should not be moved or are you flexible on the time?
Will the event be in-person or virtual?
Will the event be in-person or virtual?
Please list the whole name of a building rather than an acronym.
Will attendance be collected at the event?
We preference requests from groups that require attendance, or where students are incentivized to attend. We may ask that you provide us an attendance list following the event.
Will attendance be collected at the event?
Enter approximate number.
Which service are you requesting from the Collegiate Recovery Program?
For general information about the collegiate recovery program, visit their website: https://uhs.umich.edu/recovery
Which service are you requesting from the Collegiate Recovery Program?
If you are flexible on the date or time, please list a preferred option.
Is this a pre-set time that should not be moved or are you flexible on the time?
You may be filling this form out at various stages of the event planning process so it is understandable to pick either option.
Is this a pre-set time that should not be moved or are you flexible on the time?
Will the event be in-person or virtual?
Will the event be in-person or virtual?
Please list the whole name of a building rather than an acronym.
Enter approximate number.
Would this training be just for you or a team?
Would this training be just for you or a team?
This is a numeric only option.
Keep in mind, our dogs have limited availability.
Please submit this request at least 4 weeks prior to your event to accommodate the handlers’ schedules.
Our therapy dogs are available for time frames of 60-90 minutes. They are not available at night so please offer a time frame between 9am-6pm.
Which therapy dog combo are you requesting?
For alternative options, visit https://www.therapaws.org/#footerjump
Which therapy dog combo are you requesting?
Include the full building address and room number if available.
Refer to https://uhs.umich.edu/equity for more information on what is health equity.
Please note that our grant is specifically allocated to support initiatives targeting UM students as the primary audience.
For example, $200 for production costs, $100 for staff, and $50 for other supplies, etc. Be as specific as you can.
If yes, please provide details.
Which items would you like included?
Which items would you like included?
There are limited quantities so please be mindful of the size of your request.
Thank you for filling out the request so far. We are always happy to work with new groups and want to ask a few more questions to inform us how we can collaborate moving forward.
Have you worked with Wolverine Wellness before?
Have you worked with Wolverine Wellness before?
What is your affiliation with the University?
What is your affiliation with the University?
How did you find out about Wolverine Wellness?
How did you find out about Wolverine Wellness?
If you are a staff or faculty member, would you be interested in developing partnerships with us in the future? A partnership may include collaborating on well-being initiatives
If you are a staff or faculty member, would you be interested in developing partnerships with us in the future? A partnership may include collaborating on well-being initiatives
File attachments associated with the ticket.
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Provide a short and concise description of your inquiry i.e. “Workshop request for Career Services”
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