Creating the Extraordinary Student Experience

Health Records

 

Medical Records Release Authorization (PDF)
Complete this form to give permission to have your records released to the specified individual/business.
 
Medical & Dental History (PDF)
All patients are asked to complete both sides of this form, including signature, prior to their first appointment at Student Life Student Health Services.
 
Personal Pocket Medical History (PDF)
This form can be used to keep track of your personal medical history.