healthy bengal
TRANSCRIPT
Date: _________________ Name: _____________________________________________ DOB: _____________________ Age: ______________
Bengal ID: ____________________________________ Phone: _____________________ E-mail: _______________________________________
Referring person: ____________________________________ Phone: _____________________ E-mail: _________________________________
HEALTHY BENGALPlease complete this form to refer an individual to the ISU program or clinic you feel would be most appropriate and helpful. If the person you are referring is interested, please assist in sched-
uling an appointment. If they decline your help, he/she should take the referral form and it is their responsibility to follow up with the program or clinic and schedule an appointment when they desire. Confidentiality will be protected by FERPA and HIPAA policies.
Serving the Bengal Family
Campus Recreation*Student Recreation CenterRoom 360 • (208) 282-4854
Fitness equipment and programs‡Massage therapy†‡Personal training†‡
Center for New Directions#Roy F. Christensen BuildingRoom 372 • (208) 282-2454
Career counseling servicesPersonal counseling servicesSingle parent support services Non-traditional occupation support services
Central Academic AdvisingPocatello: (208) 282-3277Museum Bldg, Room 307Idaho Falls: (208) 282-7800Bennion Student Union
General Education requirements informationMajor or minor selection
Dietetic Programs(208) 282-2961 or (208) 282-3091
Nutrition questionsEating concerns
Disability ServicesPocatello: (208) 282-3599Rendezvous, Room 125Idaho Falls: (208) 282-7759 Bennion Student Union, Room 223
Disability accommodations
Janet C. Anderson Gender Resource CenterRendezvous, Room 235 • (208) 282-2805
Identity explorationSexual assault/relationship violence
University Counseling and Testing ServicePocatello: (208) 282-2130351 Gravely Hall South, Room 351Idaho Falls: (208) 282-7750Bennion Student Union, Room 223Free and confidential individual, group, and couple counseling for currently enrolled ISU students
Stress Management & Biofeedback Center (operated by University Counseling and Testing Service)
Reduce anxiety/stressDecrease tension/painSleep difficultiesPromote relaxationImprove awareness of mind and body
Wellness Center*Reed Gym, Room 205A • (208) 282-2117
Fitness assessments‡GET-FIT Program†‡Personal training‡Wellness coaching‡
*This program offers many free services to students, but some services require a reasonable fee.
†This service is available for a reasonable fee to students.
‡This service is available for a reasonable fee to faculty and staff.
#This program is available for College of Technology students only.
LOCATIONPocatelloIdaho Falls
Pocatello | Idaho Falls Meridian | Twin Falls
Bengal LabLeonard Hall, Room 161 • (208) 251-6260
Diagnostic testingDrug testingScreening tests (i.e., HIV, HCV)Wellness testing (i.e., CBC, lipid, and chem panels)
Bengal Pharmacy990 Cesar Chavez Ave (above the ISU Health Center) • (208) 282-3407
Medication therapy and education
Dental Hygiene Clinic999 Martin Luther King Jr. Way(208) 282-3282
Preventive careBleach traysCleaningsFillingsFluoride applicationOral health educationPeriodontal therapySealantsX-rays
Health West ISU Clinic465 Memorial Drive • (208) 234-4700Services available on a sliding-fee scale
Laboratory servicesMedical care
ISU Health CenterPocatello: 990 Cesar Chavez Ave • (208) 282-2330Idaho Falls: Bennion Student Union • (208) 282-7826
Laboratory servicesMedical careMedical nutrition therapy (Pocatello)X-ray services
ISU Hearing and Balance ClinicCommunication Sciences and Disorders Building • (208) 282-3495
Auditory processing evaluationBalance/dizziness evaluationCochlear implant servicesHearing aid servicesHearing evaluationTinnitus evaluation
ISU Physical and Occupational Therapy Associates and Balance ClinicGarrison Hall, Room 202 • (208) 282-2590
Balance/dizziness evaluation Emotional self-regulationErgonomic work place assessmentsHome safety assessments Joint health: injuries (sprains and strains)Post-surgical careRepetitive strain injuries (carpal tunnel syndrome)Sensory processing issuesWomen’s health (continence) Written communication/penmanshipVisual fine motor integration
ISU Pocatello Counseling ClinicIndividual, couple, and family counseling available on a sliding-fee scaleGarrison Hall, Room 725 • (208) 240-1609
AnxietyDepressionGrief/lossImprove wellness strategiesRelationship concernsSocial anxiety/communicationStress managementOther personal/emotion concerns:
ISU Psychology ClinicIndividual, couple, and family counseling available on a sliding-fee scale Garrison Hall, Room 533 • (208) 282-2129
Treatment for depression, anxiety, and other DSM-5 DisordersTreatment for impulse control difficultiesTreatment for trauma-related problems and interpersonal/relationship issuesAssessment and treatment for externalizing and internalizing problems in children and adolescents, including specializations in feeding difficulties, selective mutism, developmental disabilities, and Autism Spectrum DisordersChild and adult evaluations for ADHD, learning disorders, and intellectual disabilities
ISU Speech and Language ClinicCommunication Sciences and Disorders Building • (208) 282-3495Services available on a sliding-fee scale
Accent modification/reductionAlternative and augmentative communication Articulation receptive and expressive languageAdult brain injury therapy (TBI and stroke)Preschool Language ProgramStuttery/fluencyVoice therapySwallowing therapy
Pocatello Family Dentistry465 Memorial Drive • (208) 282-6000Services available on a sliding-fee scale
Hospital dentistryImplants Endodontics (root canals)Oral surgeryPediatric dentistry Preventive care Prosthodontics (crowns, bridges and dentures)
HEALTHY BENGAL------------------------------------------------------------------ Fee for Services ------------------------------------------------------------------