Forms

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. error_outline Please complete the entire packet

New Patients

New Patient Packet
If you need assistance, please call 970-351-2412.

Medical Records

If you need a copy of your medical records, please fill out and return the Medical Records Release Form.

Parents of Students

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. Please fill out and return the Consent To Treat Minor Student Form.

Immunization Requirements

Per the State of Colorado Immunization Law, all university students are required to submit proof of immunizations. If you do not have immunization records and you need a form to take to your doctor to fill out your vaccine dates, please use Certificate of Immunization for College Students Form.

Patient Confidentiality

The Student Health Center complies with the Health and Human Services privacy and security rules. For more information on how the health center protects your private information, go to the UNC HIPAA website.

Notice of Privacy Practices