One of the most significant changes to college mental health is the growing use of telehealth vendors to provide, extend, or augment mental health services provided by college and university counseling centers. In a time of sharply increased demand for services, new investments in the mental health marketplace, and the perception that mental health is a "crisis," the relationships between counseling centers and mental health vendors are increasingly important. This paper provides an overview of these new relationships, briefly reviews relevant history and context, and explores the relationship dynamics shaping this space. In addition, this paper reviews common fears and worries faced by counseling centers when considering vendors, addresses some of the confusion surround vendor/service types, and offers a set of suggestions for the inevitable future relationship in the development of guiding principle and standards.