Outreach Request Form

Please complete the form below to secure a workshop or presentation on various mental health topics. Requests for outreach events can only be made by an UH affiliate; event location must be on the University of Houston main campus. You may also email Nadine Dimaliwat at mfdimali@central.uh.edu. Please give at least a two week notice prior to a scheduled event.

Note: Due to volume of clinical responsibilities, CAPS may not be able to commit to all requests; however all requestors will receive a response.

UH Department
UH Student Organization
UH Individual (staff/faculty/student) Sexual/Physical Assault
Stress Management
Relationship Issues
Eating Issues/Disorders
Gender Issues
Sexuality
Diversity Issues
Substance Use/Abuse
Mindfulness/Meditation
Conflict Management
Suicidality (QPR training)
Self Harm
Other (please specify below)
Students
Faculty / Staff
Community
Yes
No