You will find all Student Health Center and Pharmacy clinic, pharmacy, insurance and medical forms below. If you need assistance, please call (205) 348-7961.
Clinic Forms
books-medical iconAuthorization to Disclose Medical Records
clipboard-list-check iconTravel Service Planned Itinerary Form
message-medical iconAdvance Directive
University-Sponsored Health Insurance Forms
memo-pad icon2023-2024 Student Health Insurance Summary Brochure
heart-pulse icon2023-2024 Qualifying Life Event Enrollment Form
earth-americas iconSpring 2024 Waiver Form for International Students
Medical Withdrawal Forms
Students wishing to pursue a medical withdrawal must first submit a standard term withdrawal. Medical withdrawals are governed by the Medical Withdrawal and Return to Campus Policy.
person-to-door iconStudent Request for Medical Withdrawal
building-circle-check iconRecommendation for Return to Campus
comments iconLicensed Provider Recommendation for Medical Withdrawal
