Student Health Forms

Patient Portal

 

 

The patient portal gives you access to submit forms. Click here to log in. If you have any portal problems, please contact Student Health Services at (573) 341-4284.

Consent Forms

 

 

 Consent to treat a Minor

Allergy Consent

Additional Forms

 Release of Information

MMR Waiver Request Form

NCAA ADHD Reporting Form

Missouri University of Science and Technology

Missouri S&T, Rolla, MO 65409 | 573-341-4111 | 800-522-0938 | Contact us Accreditation | Consumer Information | Our Brand | Disability Support | TERMINALFOUR

© 2018 Curators of the University of Missouri | UM System
Missouri S&T is an equal opportunity, access, affirmative action, pro-disabled and veteran employer