Header News
Header Index
Header Quick
Header Spike
Header Gift
GU Home About GonzagaAcademicsAdmissionsAthleticsCampus Resources
Student Development
Health Center
New Patient Forms
EmergenciesMandatory Proof of Immunization Policy MissionLocation, Office Hours and Contact InformationServicesInsuranceReferral ServicesImmunization Updates & RecommendationsMeningococcal VaccineFlu VaccineSharps Container Exchange MRSA Update November 15, 2007Gonzaga and SRHD Seasonal Flu and H1N1 UpdatesOnline Resources

New Patient Forms

If you are a new patient in the Gonzaga Student Health Center please download the following forms, fill them out and bring them with you to your first appointment.

Student Health Center Daily Check in Form This form must be filled out for each time a student visits the Health Center.

Health Center Demographics Form

Health History and Review of Systems Form

Notice of Privacy Practices Form


GU Home \ Student Development \ Health Center
Printer FriendlyPrinter Friendly Divider ImageTop of PageTop of Page
Prospective Students • Current Students • International Students • Employers • Alumni • Faculty & Staff • Parents & Families
© Gonzaga University • 502 East Boone Avenue • Spokane, WA 99258-0102 • (800) 986.9585 • Privacy Statement

Gonzaga University is a private Catholic, Jesuit, and humanistic university providing education to more than 7,800 students.  Situated along the Spokane River near downtown Spokane, Washington, Gonzaga is routinely recognized among the West’s best comprehensive regional universities. Gonzaga offers 75 fields of study, 26 master’s degrees, doctorate degrees in leadership studies and nursing, and a juris doctor degree through the School of Law.

Follow Gonzaga: FacebookTwitterYouTubeLinkedIn