If you are new to the Student Health Center and you want to save time checking in, fill out the New Patient Packet below, and bring it with you when you come in. IMPORTANT - PLEASE COMPLETE ENTIRE PACKET.
NEW PATIENT PACKET
Questions filling out packet? call 970-351-2412
You may fax your records release to 970-351-2427
To Parents: If your student is under the age of 18, you will need to provide a signed Consent to Treat Form prior to your student seeking care at the Student Health Center Medical Clinic. Please choose the link below to download this form.
Immunization Requirements: Per the State of Colorado Immunizations Law, all University students are required to show proof of Immunizations. Please submit your Immunization record to:
Student Health Services/ Immunizations Office
Campus Box 46
Greeley, CO 80639
email to: firstname.lastname@example.org
Fax to: 970-351-3234 or 970-351-2427