Permission to Contact Form

MSU faculty or staff members who wish to refer a student to our program for support, please fill out The Permission to Contact with the student. This form gives MSU Sexual Assault Program staff permission to make contact with the person signing the form to offer support, counseling and advocacy services. Anyone in the MSU community who has been sexually assaulted can sign the form. No one is required to sign the form. The person signing the form may designate how he/she wishes to be contacted (phone, email, in person, etc), and he/she is not obligated to meet with MSU Sexual Assault Program staff.

Permission to Contact Form