The relationship between college student health centers and counseling services is an important aspect of student wellness and success. Taking an integrated approach may provide the best foundation for providing holistic care to students (American College Health Association [ACHA], 2010). In an integrated healthcare system, students can access both health and mental health services, thus decreasing the possible barrier of stigma associated with stand-alone mental health treatment (Tucker et al., 2008). The formation of integrated health and counseling centers on college campuses provides a clear advantage for students (Davenport, 2017). Although research describes the benefits of integrated medical and behavioral health services in healthcare settings, research regarding how leaders describe the experience in college health services remains minimal. The purpose of this qualitative descriptive study, using the theoretical framework of organizational design (Bess & Dee, 2012), was to assess how leaders described their experience integrating college health and counseling services within a newly constructed or renovated facility. The research question that guided this study was:RQ1: How do organizational leaders describe their experience integrating existing health and counseling services at institutions of higher education in a newly constructed or newly renovated facility? Semi-structured interviews were conducted with an expert participant (N=1), and health and counseling leaders (N=10) involved in the integration on a college campus. Remaining data sources comprised documents and a reflective post-interview questionnaire. Rubin and Rubin's (2005) data analysis strategy were applied to interview and reflective data; Krippendorff and Bock's (2009) content analysis strategy were applied to document analyses. Five major themes emerged from analysis of the data: (1) Integration Planning for Success, (2) Leadership Attributes, (3) Communication is Key (4) The Opportunities and Challenges of Collaboration, and (5) Supporting Student Success Through Wellness. A supplemental finding emerged based on the impact of the global COVID-19 pandemic. Findings from this study may inform campus leaders and stakeholders of potential opportunities and challenges as they plan for similar projects on their own campuses. Further, this study aims to inform institutions about best practices in the integration of college health and counseling centers. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]