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Student Health 101
Call Us: 313.577.5041

Forms

Complete the appropriate forms and bring them to your appointment. All forms are in PDF format.

All patients must complete this form once per calendar year. A parent or guardian must consent if the patient is under 18 years of age.
All new patients must complete this form before their first office visit.
Female patients coming in for a yearly exam or for contraception must complete this form.
Patients coming in for any immunizations must complete this form. Vaccine information sheets will be given in the clinic.
Patients coming in for a wellness or clearance physical must complete this form.
Patients getting a sports physical must complete this form.
Patients wanting to release their health information from the Campus Health Center must complete this form.
All international students must complete the TB Screening form and make an appointment to be cleared by a nurse.
All international students must complete the TB Screening form and make an appointment to be cleared by a nurse.
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Healthy You Crew Program Request

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