College homicides and suicides often precipitate reviews of regulations, statutes and case law governing treatment and confidentiality.1 In April 2007, for example, a college senior at Virginia Polytechnic Institute and State University killed 32 students and faculty, wounded many others and then killed himself. The review panel appointed by the Governor found significant confusion among university officials about the Family Educational Rights and Privacy Act (FERPA)2, the federal law governing confidentiality of educational records, leaving them uncertain about what information could be revealed to each other as well as to the student’s parents.3 Psychiatrists seeing students as patients in college settings, either as employees of student mental health services or as private practitioners in the community, have also been confused as to their relationship to the university and the effect of federal and state laws governing confidentiality. This resource document was prepared to give practitioners a guide to providing good clinical care within the framework of relevant law.