For all new and returning clinical students please complete these forms.
Want to complete the new patient health history/consent form before your first appointment at The Health & Wellness Center? Click on the form below! (All pages should be printed out, read, and completed)
Authorization of Release of Information
Want to authorize the release of information to your family of another medical provider? Click on the form below!Authorization of Release of Information form
Flu Shot Forms
Please complete these two forms before coming to the Health & Wellness Center to receive a flu shot.
If you have documents to submit (such as immunization records or a completed physical), you can submit them via secure email to firstname.lastname@example.org.
Sending a secure email is simple! All that is required is to type [secure message] into the subject area of the e-mail message. Information that requires a [secure message] includes any health-related document. Examples include immunization records, physical forms, reports of x-rays and labs, and clinic notes.