Student Health Services Documents

Immunization Forms

Please note: Immunization requirements may vary based on student criteria. Please visit the Immunization page to view those requirements.

Medical Records/Billing Statement Request

How To Obtain Your Health Information

Download and complete the Authorization for Use and Disclosure of Protected Health Information Form in its entirety (available below) send along with a copy of your drivers license or student ID card. All forms must be signed and dated. These forms can be mailed or faxed to Student Health Services. Mailing and fax information are located at the bottom of the page. Requests without signatures will be returned.

You may also request records in person by stopping by the Student Health Services Health Information Management (HIM) Department and completing the form. The HIM Department accepts no requests for records via telephone.

Processing time for all health records is 7-10 working days.

Downloads

Authorization for Use and Disclosure of Protected Health Information Form

Please note: some items require the Adobe Acrobat PDF Reader, which can be downloaded from the Adobe web site.

The Counseling Center

Walk-Ins

If you come in for Walk-In services, you will be asked to complete the “What Type of Services Do I Need” form(PDF) to help determine what type of appointment would best meet your needs. If it is determined that your needs are urgent, you will be asked to complete initial paperwork before being seen by the Walk-In/Urgent counselor.