Assessment & Consent Information

Assessment Information and Consent Form


Psychological Assessment is utilized for one of two broad purposes at the Texas State Counseling Center:


1.  To enhance a student’s experience with counseling and provide information

     related to their reason for seeking counseling,


  1. To address a  direct referral from another university office (e.g., Office of   

      Disability Services) to address a specific question (usually related to academic



I can expect that the staff member completing the assessment with me will carefully review the purpose and goals of the assessment and explain the procedures that will be used.


I understand that the testing process typically consists of one or more sessions during which tests are administered, and a follow-up session in which the test results as they relate to the original goals of the assessment will be discussed with me.  Sometimes a formal written report of the test findings will be created and other times the information will be summarized in a briefer format.  Either way, the test results will become a part of my official record at the Counseling Center.  These records are confidential and will be released only with my written consent or as required by law.  Raw test data (e.g., test questions with answers) will be released only to another qualified professional.   In situations where the Office of Disability Services has specifically referred you for this evaluation, signing this consent form gives permission for consultation and sharing of testing information (verbal and written) between the Counseling Center and the Office of Disability Services and for the Counseling Center to provide the Office of Disability Services with a copy of the final written report.


I understand that psychological assessment at the Counseling Center is totally voluntary and can be discontinued at any time.  If I experience discomfort, or have questions or concerns during the assessment, I will share my concerns with the staff member working with me. I realize that it is not unusual to experience anxiety or fatigue from an assessment but that typically this is mild and of short duration. 


I realize this assessment is a collaborative effort between myself and the evaluator designed to address the specific questions or concerns that have been agreed upon and that my full participation will enhance the usefulness of the evaluation.  I accept that while the evaluation can provide valuable information to me, no specific results can be guaranteed.


I have read and I understand the information described on this consent form.  I would like to proceed with the psychological assessment. 




Name (Please Print)


____________________________________                 ______________

Client Signature                                                            Date


____________________________________                 ______________

Evaluator Signature                                                      Date