Patient Forms

Please arrive 15 minutes prior to your appointment time to complete any associated forms.

Patients are provided with information regarding their right to privacy.  You will be asked to review the Notice of Privacy Practices and sign the Privacy Acknowledgment Form, which is now included in the Self Check-In process in our clinic.

Notice of Privacy Practices

For Study Abroad Health Physical Exams, please complete the below form and bring it with you to your appointment:


Please visit the Release of Records Request page for information regarding requesting your health records from Health & Counseling Services.