Health Center 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.

Student Health Advisory Committee (SHAC)

The Student Health Advisory Committee (SHAC) acts as a student voice for the University Health Center staff and administration.

Patient Satisfaction Assessment Survey

The University Health Center (UHC) cares about you and your patient experience. We strive to meet our mission and provide high quality, cost-effective health care and wellness programs in order to promote health and support your academic success. We want to be your provider of choice for health care and health information, recognized as a leader in collegiate health care, to be an important source of services for faculty and staff, and to be an integral part of the University’s educational mission.

Patient Rights and Responsibilities

The University Health Center recognizes its responsibility to respect the basic human rights of all patients who seek treatment here. It also defines the responsibilities of patients of the University Health Center.

To learn more about patient rights, responsibilities, and confidentiality please see the tabs below.

Notice of Privacy Practices

Notice of Privacy Practices

As Required by the Privacy Regulations Created as a Result of the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA).

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION

PLEASE REVIEW THIS NOTICE CAREFULLY. 

I. OUR COMMITMENT TO YOUR PRIVACY