Campus Health Center
Online
Payment
Patient
Portal
Forms Schedule
Appointment
  • Our Services
  • Mental Health Triage
  • About Us
    • Staff
    • Our Mission
    • Our History
    • Awards/Memberships
  • Resources
    • COVID-19 Testing
    • COVID-19 Vaccine/Booster
    • Flu
    • Monkeypox
    • Forms
    • Referrals, Policies, Handouts
    • Campus Resources
  • Outreach
    • Health Programs
    • Flu Immunization
    • Travel Health
    • Sexual Health
  • FAQ
  • Search
  • Facebook
  • Twitter
  • Instagram
  • Online Payment
  • Forms
  • Schedule Appointment
  • Patient Portal

Forms

Enrollment Form

Complete your form before your first visit to CHC and then annually moving forward.

Enrollment Form - Parent Guardian

Please have your parent or guardian complete your form before your first visit to CHC and then annually moving forward.

Medical Records Release

Complete the Medical Records Release form when you need CHC to release your medical records to someone outside of the clinic, or if you need CHC to request records from someone else. There are two forms; Ask us for questions/clarification.

TB Risk Assessment Outreach Form

TB Assessment English

Complete the TB Assessment Form in your language of choice if you are an international student coming to CHC for your TB clearance appointment for the first time, or if you’ve been back to your home country for 30 days or more.

TB Assessment Chinese

Complete the TB Assessment Form in your language of choice if you are an international student coming to CHC for your TB clearance appointment for the first time, or if you’ve been back to your home country for 30 days or more.

TB Assessment Arabic

Complete the TB Assessment Form in your language of choice if you are an international student coming to CHC for your TB clearance appointment for the first time, or if you’ve been back to your home country for 30 days or more.

TB Assessment Portuguese

Complete the TB Assessment Form in your language of choice if you are an international student coming to CHC for your TB clearance appointment for the first time, or if you’ve been back to your home country for 30 days or more.

Campus Health Center
USEFUL LINKS
  • Patient Portal
  • Patient Resources
Hours

Monday-Friday
9:00 am to 5:30 pm
After Hours Urgent Care

STAY CONNECTED
  • Promotion Rules
Location

5285 Anthony Wayne Dr.
Detroit, MI 48202

Directions
Campus Health Center Map
Wayne State Campus Map
Campus Resources

Contact Us

Phone: 313-577-5041
Fax: 313-577-9581
campushealth@wayne.edu

wsu-shield

wsu-shield

Privacy Policy | 2023 © Campus Health Center.