Forms

To minimize your wait time at the Health Center, we have provided you with some forms to print and fill out prior to your appointment.

All files are in PDF format. You'll need Adobe Reader to view these files. Image removed.

Allergy Clinic

Class Excuse Self-Signed Note

 Immunizations

Medical Records

Mental Health

Prior to your first appointment at the Mental Health Service, go to myuhc.umd.edu and complete the questionnaires for your appointment (you must have an appointment scheduled in order to be able to complete the paperwork).  Don't forget to click "SUBMIT" when you are finished.  Please do not print the questionnaire and bring it to your appointment.  If you are unable to complete this paperwork prior to your appointment, you can arrive 20 minutes early to your appointment to complete the questionnaire on one of our computers.

Occupational Health

Animal Handler Questionnaire

Initial Asbestos

Periodic Asbestos

Respirator Physical

Employment Physical

Vaccinia (Small Pox)

TDap

Physical Therapy