Student Wellness Services

Student Wellness Services

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Forms

Are you a new patient? Please complete the following forms and bring them to your first appointment:

Domestic Students: Patient Demographic and Privacy Forms

International Students: Patient Demographic and Privacy Forms

Are you requesting an appeal? Please fill out the following form and return it to Student Wellness Services:

Appeal request

Do you wish to have your records transferred to us or from us? Please complete the following form and return it to Student Wellness Services:

Consent to Release Information