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Document(s) in the category of Student Health/Counseling. Number of document(s) found: 13
Note: i=interactive
Titleasc descDescriptionCategoryasc desc
Allergy History Screening Formi PDF document Used to record allergy history. This form is to be completed by the student. Student Health/Counseling
Authorization for Release of Medical Records PDF document This form authorizes SUNY Upstate Medical University Employee/Student Health Service to copy and release specified medical information to the name or facility listed by the requesting person. It must be completed, by you, in full and signed. Student Health/Counseling
Authorization for Release of Medical Records to Upstate Medical University PDF document This form authorizes the listed Primary Care Provider or facility to release specified information to SUNY Upstate Medical University Employee/Student Health. Student Health/Counseling
Blood & Body Fluid Exposure Protocol PDF document Blood & Body Fluid Exposure Protocol Student Health/Counseling
Certificate of Health Statement PDF document There are no exceptions, all students must complete this form Student Health/Counseling
Meningoccal Fact Sheet PDF document Basic facts about Meningoccal disease and vaccine Student Health/Counseling
Meningococcal Vaccine Response Form PDF document New York State Public Health Law requires that all college and university students enrolled for a least six (6) semester hours or the equivalent per semester, or at least four (4) semester hours per quarter, complete and return this form to SUNY Upstate Medical University Employee/Student Health. Student Health/Counseling
Report of Medical Examination PDF document Completion of this form requires a physical examination. All sections of this form are to be completed by your health care provider, with each item marked individually (no lines through will be accepted). The forms must be signed, dated and stamped by your health care provider and include address and phone number. Student Health/Counseling
Student Authorization for Release of Medical Information PDF document Student Authorization for Release of Medical Information Student Health/Counseling
Student Health Form PDF document To be completed by the student with each item being checked and an explanation for all "yes" answers in the space provided. You may use an additional sheet, if necessary. Your health care provider needs to complete the summary section, sign and date. Student Health/Counseling
Student Health Insurance Packet PDF document Student Health Insurance Packet Student Health/Counseling
Student Immunization Form PDF document All sections need to be completed by your health care provider. Laboratory testing for antibody titers is required and copies of the laboratory report must be returned with the form. Dates of immunization alone are not acceptable. Student Health/Counseling
Women's Health Services & Contraceptive Counseling PDF document Women's Health Services & Contraceptive Counseling Student Health/Counseling