Forms and Policies

For some services, we'll need some additional information or written permission to ensure we can serve students effectively. 

Here, you'll find the most common forms and policies students and their families should be aware of. Keep in mind that some departments may have additional policies or forms for you to complete before connecting you with services we offer. 

Disclosure of Health Information

• ADD/ADHD Patient Authorization for Disclosure of Health Information Form
• Patient Authorization for Disclosure of Health Information Form (Student Health Services-specific)

Financial Responsibility

• Financial Responsibility Form

Immunization

• MSU Immunization Policy for Students 
• Immunization Self-Report Form (Mandatory)

Patient Rights and Privacy

• Patient Protection and Rights: Safety Protocols, Nondiscrimitionation Notice and Reporting Options Acknowledgement Form
• Notice of Privacy Practices

 

 Forms and policies specific to Student Health Services are available here.