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Forms

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First Aid Kit Loan Request - The UHC has first aid kits to loan JMU student groups for travel.  The designated JMU Faculty/Staff advisor for the group may request kits with this form.

Grievance Policy and Form - For students who would like to formally make a complaint or grievance regarding their dissatisfaction with the UHC.

Health Information Receipt - For students requesting a copy of their entire health record. Requires a $10 fee and must accompany the 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 fine and academic hold. Due:

  • July 1, 2016 for summer or fall 2016 semester start
  • December 9, 2016 for spring 2017 semester start

Religious Exemption Form - For students exempting immunizations due to religious reasons.