Downloadable Forms

Know exactly which form you need?

Here are quick links to all the forms described on this page:

All forms are Adobe PDF files. If you have trouble viewing the form you need, you may need to install the free Adobe Reader application, available here.

 

INSURANCE CLAIM FORMS:
For UC SHIP related forms please see the insurance page HERE.

 

CONSENT FOR CARE OF MINOR
Students under 18 years old must have their parent/guardian(s) provide consent for medical care at the Student Health Center.

 

MEDICAL RECORDS RELEASE
We provide copies of medical records, partial or complete, when requested. Records can only be released by, or to, the patient with a signed release form. If you are under 18, your parent/guardian must be the one to sign and complete this form. Please allow 15 days to process your request. Records will mailed faxed, or picked up, we DO NOT email records.

 

MCD BIOLOGY APPEALS

If your college asked you to submit a Verification of Health Condition Form, you can first read the instructions here, then download the form.