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

 

ADD/ADHD Information

Advance Directives and Living Wills

Consent For Treatment Paper Version Form *

COVID Vaccine Consent Questionnaire

EUSHIP Continuation Application

EUSHIP Voluntary Dependent Enrollment Application

FERPA (Family Education Rights and Privacy Act) Documents

Financial Policy Paper Version Form *

Health Insurance Requirement Waiver Appeals Process (no longer a form; contact mandatoryinsurance@listserv.cc.emory.edu)

HIPAA Authorization For Use/Disclosure of PHI Form

Immunzation Forms

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)

 

 

Student Health Services

Emory University Student Health Services (EUSHS) provides outpatient care for enrolled Emory students with a valid Emory ID card. International student's spouses, Domestic Partners and unmarried children over 18 years of age are also eligible for primary medical care if they are currently enrolled in the Emory/Aetna Student Health Insurance Plan.

Phone Number

404-727-7551

Contact Us

Location

1525 Clifton Road
Atlanta, Georgia 30322

Hours and Location/Directions

Patient Portal

Schedule appointments, request prescription refills, send secure emails and more.

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