Skip to content
Search for:
Toggle Navigation
Cart
Menu
About WUSA
Governance
Elections
Nominations
Referendums
Student Bodies
Board of Directors
Student Societies
General Meetings
Library
Awards
OUSA Teaching Awards
WUSA Leadership Awards
WUSA Volunteer Awards
Orientation
Your Money
Budgets
Fees
Funding
Image Gallery
Accessibility
Contact Us
Advocacy
The Change Engine
Housing Playbook
Position Statements
Experiential Education
Gender-based and Sexual Violence
International Student Tuition
Local and Regional Transit
Mental Health
Off-Campus Housing
Research & Consultation
Clubs
Events
Jobs & Opportunities
News & Updates
Services
Food & Retail
Chaska
FedBus
Flock Stop
SmashBites
The Dispensary Cafe & Lounge
WUSA Used Books
Student-run Services
Bike Centre
Centre for Academic Policy Support (CAPS)
Co-op Connection
Food Support Service
Glow Centre for Sexual and Gender Diversity
International and Canadian Student Network
Mates
Off Campus Community
Racial Advocacy for Inclusion, Solidarity, and Equity (RAISE)
Women’s Centre
WUSA Thrift
Student Supports
Empower Me
GRT U-Pass
Health and Dental Plan
Poster Run
Student Legal Protection Program
Sustainability
WUSA Thrift
The WUSA Sustainability Project
WUSA Sustainability Directory
Membership Deals
Turnkey Desk
Shop
Donations
Memberships
Products
Account details
The Women’s Centre Peer Support Form
Home
Services
Student-run Services
Women’s Centre
The Women’s Centre Peer Support Form
The Women’s Centre Peer Support Form
2022-04-28T10:08:14-04:00
Please enable JavaScript in your browser to complete this form.
Your Full Name
*
Preferred Name
uWaterloo Email
*
Academic Term (e.g. 2B, 4A, etc)
Program
Please select if your prefer online or in-person
Online
In Person
Appointment Time Slot (First choice)
Date
Time
Appointment Time Slot (First choice)
Date
Time
Appointment Time Slot (Second choice)
Date
Time
Appointment Time Slot (Second choice)
Date
Time
Appointment Time Slot (Third choice)
Date
Time
Additional Details
Please provide any additional information you feel would be helpful for us to know about your request. This will be shared with the peer support volunteer that will be talking with you. Refrain from including detailed confidential information.
Support Session Type
Audio Support Session
Video Support Session
This is not relevant if you're choosing an in-person peer support session. Although we prefer Video sessions as it helps us to connect with you on a more personal level, we also understand that there can be technical issues or other concerns where you may prefer an audio only session.
Confidentiality
*
I accept
Everything you talk about in your Women's Centre peer support session will be kept confidential; however, if you tell us or if we have reasons to believe that you are at the risk of harming yourself or others, we will have to break confidentiality and connect you with more professional support services immediately
Submit
Page load link
Go to Top