Forms and Information

If you have questions or concerns, please feel free to contact SHS by phone or email.

Commonly Used

• Consent for Medical Treatment of Minors (PDF) — This is used for any student under 18 years of age seeking health care at SHS. The form must be signed by a parent/guardian and faxed to our Medical Records Department. If you have questions, call or email Medical Records.
• Notice of Privacy Practices — HIPAA (PDF) — These are your rights and our obligations regarding the use and disclosure of your medical information in accordance with state and federal regulations.
• Letter to Professors (PDF) — A letter to professors regarding our medical excuse policy.

Insurance

The Health Fee Waiver application is available online through the Health Fee Waiver Tool in the TritonLink Toolbox. Read more about waiving UC SHIP and find additional insurance forms and information on the SHW Insurance site.

Medical Records

To request a copy of your medical records, or to request we send your medical records to another health care provider, complete and submit the Authorization to Release or Exchange Confidential Information form. Instructions and contact information can be found on our SHW Medical Records site.