Contact the DRC Appointment and General Information Request Please respond to the questions below and someone will contact you as soon as possible.If you have any difficulty with this form, please call the DRC at 760-744-1150, ext. 2375.(NOTE: This form is not an application to the DRC program, the application can be found here: Apply to the DRC)NOTE: Remote DRC Drop-In Counseling is held Monday through Thursday, 10:00AM-2:00PM and Friday from 11AM-12PM If you are interested in a DRC Counselor calling you for a 10-15 minute phone or Zoom drop-in counseling session, email drc@palomar.edu or call 760-744-1150, ext. 2375 during this timeframe.Your Name* First Last Palomar Student ID* Email Address* Enter Email Confirm Email Phone Number*Is the phone number you provided one of the following: Cell Phone Home Phone Video Phone No Phone Number Are you a current DRC student?* Yes No How can we help you? (check all that apply)* Requesting a counseling appointment with a DRC Counselor Requesting updated accommodation/Accommodation Letters I have a question involving test proctoring Alternate media (electronic textbooks or assistive technology) DHH Services (ASL interpreting, captioning, assistive listening device, etc.) Other Briefly describe your question or request:* Your preferred method of communication:* Email Phone Video Meeting (thru Zoom) FERPA Disclaimer:*Due to the abrupt transition to remote services as a result of the college response to the COVID-19 virus, DRC is seeking to maintain services for students through creative ways. In order to comply with Family Education Rights and Privacy Act (FERPA), a two question identification authentication will be required prior to releasing student academic information over the phone, or in the remote counseling environments. I grant permission for Palomar DRC to release my academic information during a remote counseling appointment conducted by phone, email or video (Zoom). Click to acknowledge that you have read and agree to the above paragraph. Δ
