Testing Center
Psychological Test Request
UNIVERSITY OF UTAH
TESTING CENTER
STUDENT SERVICES BUILDING

201 S 1460 E RM 498
SALT LAKE CITY UT 84112-9059
  OFFICE: (801) 581-8733
  FAX: (801) 585-1932
  WEB: www.sa.utah.edu/testing
  EMAIL: testingcenter@sa.utah.edu
Instructions:

Counselor
: In order to have your clients tested at the Testing Center, you must either be on the staff of the University Counseling Center, or on the Testing Center's Approved Counselor's List. If you meet this criteria, please provide the Testing Center with a completed Test Request for each client you wish to have tested. This may be dictated over the phone if necessary. It is also recommended that you supply your client with a copy of their Test Request, and that you direct him or her to follow the instructions it contains.
 
Client: Please come to the Testing Center during Paper-Based Testing Hours, allowing enough time to finish the test(s) before closing time. Be prepared to present your copy of the Test Request, provide a photo ID, and pay all applicable testing fees shown below.
 
Paper-Based Testing Hours:
 
MONDAY
8:00 am - 3:00 pm
(day)
TUESDAY
4:30 pm - 8:30 pm
(evening)
WEDNESDAY
8:00 am - 3:00 pm
(day)
THURSDAY
4:30 pm - 8:30 pm
(evening)
FRIDAY
8:00 am - 3:00 pm
(day)
Client: 
 
Date: 
 
Tests to be Administered: Fee:         
   
CISS _________
DAT _________
MBTI _________
MCMI II _________
MMPI 2 _________
NEO-PI-R _________
SASSI _________
SCAT _________
SCL 90-R _________
SII _________
16 PF _________
Other: _________
Other: _________
 

Total: 

_________
   
Counselor: 
 
Agency: 
 
Address: 
 
 
Campus Mail: 
 
Phone:
FAX: 
 
Charge:
Client   Counselor   Practicum Account   Other
 
University Affiliation Discount:
Yes   No