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 email@example.com or at (574) 631-7497. We’ll make sure you obtain the necessary paperwork.
Student medical services are confidential. In accordance with Indiana state and federal laws governing privacy, University Health Services (UHS) will not share a student’s information outside of the healthcare community without a student’s express permission. However, in the event of an emergency, a family member or guardian will be notified promptly if a student is in immediate danger or admitted to a hospital or other healthcare facility.
Please note: In order to use our forms, you’ll need Adobe Reader.
- Authorization Form for Consent for Treatment of a Minor
- Consent to Acquire Information from Medical Records to Release to UHS
- Information and Forms for Students on Allergy Immunotherapy
- Immunization Form
- Medical Records Release Form (use when requesting UHS medical records be sent to any medical practice)
- Prescribed Stimulant Medication Form
- Vaccine Exemption Request Form
- Summer Scholar and Leadership Seminar Exemption Request Form
- ND Wellness Center Eligibility Link to Sign Up Dependents
For Notre Dame Student-Athletes:
Your Athletic Trainer will contact you with the necessary forms.