Release of Information Form ( PDF – please print and sign the form)
*Please contact our office at 660-785-4014 if you have any questions or concerns about this form.
- MAIL: You may mail the signed form to our office:
Truman State University
ATTN: University Counseling Services
100 E Normal Ave.
Kirksville, MO 63501
- FAX: You may fax the signed form to our office at 660-785-7444.
- EMAIL: You are also welcome to scan the signed form and email it to us at firstname.lastname@example.org (we will email you back to confirm receipt of your signed Release of Information form).