Communication Skill Centers are dedicated to adapting services in order to best meet the needs of their clients. The authors felt it was necessary to explore how their center could offer and support online mediated services. For the past two years they have incrementally developed and piloted asynchronous (submit and respond) and synchronous (real time video) online service offerings. It was through the experience of building online mediated services that they were motivated to learn more about what other centers around the country are doing to meet the needs of their clients. Consequently, through this study, the authors hoped to learn how fellow centers are engaging in online mediated services. In this article, the authors first explore briefly the relevant literature. Second, they present the methodology for the study. Third, they report the results. Finally, they analyze the results in the discussion section.