Forms

Release of records

Email a request for medical records to StudentHealthService@wusm.wustl.edu

Individual Authorization for WUSM Student Health

3rd Party Authorization for ROI-Student Health Services

MO AUTHORIZED RELATIVE CERTIFICATION – WUSM Student Health (002)

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Benefits

SHS Benefits Dependent Enrollment

SHS Benefits Dependent Verification Affidavit

SHS Benefits Domestic Partner Verification

Incoming student paperwork

Health History

Physical Exam

Immunity History

Students can email these forms to StudentHealthService@wusm.wustl.edu or to Betty Feagans at feagansb@wustl.edu.