Wellness Center - Forms

Health History and Physical Exam Form (pdf)

Authorization for Release or to Obtain Medical Records (pdf)

Meningococcal Meningitis Information Public Health Law 2167

Meningococcal Vaccination Response Form (pdf)

How to use fillable forms with digital signature:
Download forms to computer and open with any PDF reader (for example: Adobe reader can be downloaded and used for free). Once opened in a PDF reader, you will be able to fill out the form and create a digital signature in order to sign. Once the form is completed, save to your computer and submit to the Wellness Center.

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