Insurance Resources
Insurance Resources can be found at:
http://www.HealthCare.gov
http://www.1stagency.com/shortterm.php
Forms
All medical information is confidential and will not be released without written, informed consent. To obtain your medical information from Student Health Services, or to allow for your medical information to be sent to Student Health Services, please print, complete, sign and send the applicable form. Please include the ‘Medical Records Request Form’ with either release form to provide the necessary information. Requests for medical records require up to five open business days to process (we are closed during holidays, school breaks and the summer).
When requesting complete records, there is a 50 cent per page copying fee, not to exceed 10 dollars. We reserve the right to charge for postage. We will let you know by telephone or email how much the total charge will be once we retrieve your records from our archives. You may pay the fee, prior to the release of the information, by mail or credit card in the business office, or in person should you wish to pick up your copy in person.
For medical records, here are a various forms that may be helpful to you:
Medical Records Request Form
Authorization to Release Medical Records
For entrance requirements, the following forms may be useful:
Medical History Form
Tuberculosis Self-Screening Tool
Consent for Minors
Immunization Exemption Form
Before your Appointment you will want to read and/or complete these forms:
Financial Responsibility Form
Notice of Privacy Practices
Listed below are some of the various Student Health Services policies that apply to students and patients:
Patients Rights and Responsibility
Policy Regarding Minors
Immunization Exemption Policy
Appointment Policy
Absence Policy
Allergy Contract