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 current 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 required for care. 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. We require a 72-hour advance notice to provide time to review, copy and prepare the record(s) for mailing, faxing, or pick up. For more information click here.