Health Services
Student Health
Forms
Student Health Forms can be retrieved by clicking on the following links:
- ADD/ADHD Questionairre (PDF)
- Authorization for Treatment (PDF)
- Authorization to Release Medical Information (PDF)
- Contraceptive Renewal Form (PDF)
- Demographic Information Form (PDF)
- IUPUI TB Questionnaire (PDF)
- Pap Exam Questionnaire (PDF)
- Patient Report of Medical History (PDF)
- Residential Student Immunization Requirements (PDF)
- STI Questionnaire (PDF)
- UTI Questionnaire (PDF)
Some files on this page are PDF documents and require Adobe Reader.


