Forms

Forms used at the University of North Dakota, Student Health Services

Mandatory Forms

Mandatory Health History & Immunization Form and TB Screening Form
All new students are required to fill out the forms and bring it to Student Health Services

Your Privacy Forms

Student Health Privacy Policy

Authorization for Disclosure of Medical Records to Student Health Services

Authorization for Disclosure of Medical Records to Other Facility

Consent to Treat Minor Child

Other Forms

Insurance Guideline for Gardasil

Pap Smear Form

Physical Form

FAA Medical Form (Complete form online and print copy to bring to clinic)

 

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