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

Patients are also provided with information regarding their right to privacy.  You will be asked to review and acknowledge these rights during your first visit the Health Center.

Notice of Privacy Practices