University Health Services Forms

Health Compliance

Health Compliance forms are required for ALL new FSU Students prior to registration

• Healthcare Compliance Checklist
• Health Compliance Forms
• Health History Form  (Form 1)  (REQUIRED)
• Student Immunization Record (Form 2)  (REQUIRED)
• Patient Disclosure Authorization (Form 3)  (REQUIRED)
• Healthcare Compliance Packet (contains all necessary forms listed below)
• Healthcare Compliance Information
• Dropbox Instructions
• Privacy Policy
• Vaccine Information

• STUDENT Request for Waiver of Insurance Coverage for Pregnancy
• PARENT Request for Waiver of Insurance Coverage for Pregnancy

Nutrition Clinic

• Nutrition Intake Form (pdf)

Faculty/Staff

• Authorization to Treat (pdf)