Forms for Your Appointment
We have several forms that you may need to complete at your appointment. For your convenience, you may complete them prior to coming in. Please click on the appropriate forms below to download and print.
You will need Adobe Reader installed to view and print all of the forms below. For a free download of the latest version of Adobe Reader click here.
New Medical Care Patients
If you are a new patient or a patient returning a year after your last medical visit, please complete and bring the following form to your appointment.
New Mental Health Care Patients
If you have scheduled your first mental health appointment, please complete and bring the following form.
Gynecology & Contraception Patients
If you are coming in for a gynecology or contraception appointment, please complete and bring in the following form. If this will be your first appointment at the Student Health Center, please also complete the 'New Medical Care Patients' form found above.
Allied Health Students
If you are an allied health student coming in for a physical exam, please complete and bring in the form below. If you are also coming in to the Student Health Center for the first time, please complete the 'New Medical Care Patients' form found above.
If you are a minor (under the age of 18), please have your parent or legal guardian complete the following form for you to bring in. If you are coming in for contraception, pregnancy testing, STI testing/treatment, or mental health crisis, you are not required to have your parent or legal guardian complete the form.