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  1. University Health Clinic
  2. How to Access Care
  3. Forms

Forms

How to Access Care
  • Forms

New Patients


If you are new to the Health Clinic and you want to save time checking in, fill out the New Patient Packet and bring it with you when you come in. Please complete the entire packet. If you need assistance, please call 970-351-2412.

Download New Patient Packet

Medical Records Release


If you need a copy of your medical records, please fill out and return the Medical Records Release Form.

Download Medical Records Release Form

Consent to Treat a Minor Student


If a student is under the age of 18, the student’s parent or guardian may need to provide a signed Consent to Treat Form prior to the student seeking care at the Health Clinic.

Download Consent to Treat Minor Form

Patient Confidentiality


The Health Clinic complies with the Department of Health and Human Services privacy and security rules.

Notice of Privacy Practices 

Immunization Requirements


Per the State of Colorado Immunization Law, all university students are required to submit proof of immunizations. If you do not have immunization records and you need a form to take to your doctor to fill out your vaccine dates, please use the Certificate of Immunization for College Students Form.

Certificate of Immunization for College Students Form

 

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