Forms

Health information receipt - For students requesting a copy of their entire health record. $10 fee and must accompany Health Information Release form.

Health information release - For FORMER students requesting any portion of their health record. Current students can do this from MyJMUHealth.

Hepatitis and meningitis immunization waiver - Needed for any student who would like to waive these vaccines.

Immunization form - State required, must be signed by healthcare provider, dates entered into MyJMUHealth, and returned to UHC at address on form. Non-compliance will result in $50 fee and academic hold.

Nutrition forms - Complete for initial visit with registered dietitian.

Religious exemption form - For students exempting immunizations due to religious reasons.