Patient Record and Permission for Treatment

Prior to treatment at Student Health Center, the patient is required to complete a short personal medical history form. All patient medical records are confidential. This information is not released to any source, University or otherwise, without the written consent of the patient, except as required by law or court order. Please click here to print a copy of the Student Health Center Health History Form.  When authorized to release medical records they will not be transmitted via facsimile. All medical records properly authorized for release will be mailed.

Patients who are 18 years of age or older may sign the Permission to Treat form.  Patients under the age of 18 must have the Permission to Treat form signed by their parent or legal guardian. In the event that this form is not on file at Student Health Center, an attempt will be made to contact the parent or legal guardian to obtain permission to treat the patient, only one time, if non-emergency. The Permission to Treat form may be obtained at Student Health Center.