* Forms indicated with an asterisk require a parent/guardian signature if the student is under 18 years old.

* Because you are under 18 and unable to complete the forms electronically, the Patient Portal will not update to show you as compliant, but once the forms are received they will be added to your record. 

ADD/ADHD Information

Advance Directives and Living Wills

Consent For Treatment Paper Version Form *

COVID Vaccine Consent Questionnaire

FERPA (Family Education Rights and Privacy Act) Documents

• Family Educational Rights and Privacy Act (FERPA) Notice
• FERPA-Consent to Disclosure of Personally Identifiable Information* (may be shared with other university departments)

Financial Policy Paper Version Form *

Health Insurance Requirement Waiver Appeals Process (submit an inquiry here)

HIPAA Authorization For Use/Disclosure of PHI Form

Immunzation Forms

• 2024-25 Health Science Program (Allied Health, School of Medicine, School of Nursing only) 
• 2024-25 Non-Health Science Programs (Business, Laney, Law, Public Health, Theology, Undergrad)
• 2024-25 Medical Exemption Form
• 2024-25 Religious Exemption Form
• 2024-25 Meningococcal Acknowledgement * (Required for all students living on campus)

Medical Records Release Form

Mental Health Consent for Treatment Paper Version Form *

TeleHealth Consent Paper Form *

Emory Healthcare and Emory University Privacy Practices Notice

Physical Exam Form for Health Sciences Students (only for Allied Health, Medical and Nursing students)

(Parking Map, version 1/ Directions from EUSHS to Emory Clinic)

(Parking Map, version 2/ Directions from EUSHS to Emory Clinic)