Forms

HEALTH STATUS REVIEW FORM
Download (.pdf)

AUTHORIZATION FOR RELEASE OF INFORMATION
Download (.doc)

RECORDS RELEASE/REQUEST FOR PAP EXAM WITH RESULTS AND BIRTH CONTROL PRESCRIPTION
Download (.doc)

AUTHORIZATION TO PROVIDE MEDICAL OR NURSING TREATMENT FOR STUDENT/S ATTENDING SHEPHERD UNIVERSITY UNDER THE AGE OF 18 (EIGHTEEN)
Download (.doc)

CERTIFICATION OF ILLNESS
Download (.doc)

Health Center

Location: Gardiner Hall
Hours: Mon-Fri 8:00-4:30
Phone: 304.876.5161
Fax: 304.876.5509