Chances are, we have the form you’re looking for.
If you can’t find the form you seek in the list below, please contact us at firstname.lastname@example.org or at 574-631-7497. We’ll make sure you obtain the necessary paperwork.
Please note: In order to use our forms, you’ll need Adobe Reader.
- Authorization Form for Consent for Treatment of a Minor, 27k PDF
- Consent to Acquire Information from Medical Record to release to UHS, 191k PDF
- Information and Forms for Students on Allergy Immunotherapy, 42k PDF
- Instructions for using online Student Health, 999k PDF
- Medical History and Physical Report, 558k PDF
- Medical Information Release Form, 162k PDF
- Meningitis Information Signature Form, 66k PDF
- Online Student Health
- Patient Satisfaction Survey
- Post-Travel Survey, 96k PDF
- Prescribed Stimulant Medication Form, 118k PDF
- Refusal of Care Against Medical Advice Form, 271k PDF
- Supply Request Form (Google doc)
- Training Room Reorder Form, 309k PDF
- Travel Service Survey, 77k PDF
For Notre Dame Student-Athletes:
Fill out the following forms and return them to UHS prior to your physical exam.