The increase in the level of severity of student psychological difficulties and the growing need for psychological services in higher education settings has placed considerable pressure on college and university mental health services to respond effectively to this demand. One way several of these services have responded has been to implement clinical triage systems. Though these systems have been well developed in physical health settings, their use in mental health services, especially higher education mental health settings, are still novel. The present article outlines the processes and procedures involved in developing and implementing a clinical triage system through the perspectives of two sites. Issues addressed include how a mental health service moves to the utilization of a clinical triage system, the processes and components involved in the successful transition to a clinical triage system, the impact on the campus and a discussion of the risk management implications of implementing a clinical triage system. (Contains 2 figures.)