Student Wellness Services

Student Wellness Services

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Forms

Are you a new patient? Please fill out the following forms and email them to health.services@queensu.ca prior to your first appointment:

Domestic Student Patient Demographic and Privacy Forms

International Student 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