How to Request Documentation
If you need a letter verifying that you are receiving services through the MHWC, you can use the form below to request a letter from us. (For example: You may be asked for this kind of letter as documentation if you are requesting an excused withdrawal from a class.)
- In most cases, this form should be filled out by the student who is receiving services from the MHWC.
- If necessary, a counselor can submit the form on a student's behalf.
This form must be emailed to mhwc@deanza.edu at least seven business days before it's needed, to provide enough time for the MHWC staff to complete the paperwork. Requests will not be granted during finals week.
Requirements to Qualify
- You must have an established professional relationship with an MHWC counselor and have attended at least three sessions with this clinician.
- Your sessions with an MHWC counselor must have occurred within the last two academic quarters.
How to Submit Your Request
- Click the button to download the form
- Complete the form, print it out and sign it
- Scan and email the form to mhwc@deanza.edu at least seven business days before the documentation is needed
- If you qualify, the letter will be provided via encrypted email or be available for pick up at the MHWC in RSS 258 within seven business days of the date your request is submitted.