University Health Service

Immunization records form (online):
All new students (or their parent/guardian) should submit their immunization records, preferably at least 30 days before classes start. This information may be used to provide health care for students.

Parent / Guardian Consent for a Minor to Receive Health Care Services:
Only for students under the age of 18; a parent or guardian should complete this form.

Authorizations to Release Protected Health Information:
Need your health records? You can choose from two different forms:

  • To request a copy of your health record OR
  • To allow verbal communication

Behavioral Health Consent Form:
All patients in our Behavioral Health Clinic are required to review, sign and return a Consent to Treat form, typically at their initial appointment.