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 icon2024-2025 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