Forms

• Forms
• Consent Forms
• Medical Withdrawal
• Medical Records

You will find all Student Center and Pharmacy clinic, pharmacy, insurance and medical forms below. If you need assistance, please call 205-348-7961.

Clinic Forms

Authorization to Disclose Medical Records
Travel Service Planned Itinerary Form (PDF)

Advance Directive (PDF)

University Sponsored Health Insurance Forms

2023-2024 Student Health Insurance Summary Brochure
2023-2024 Qualifying Life Event Enrollment Form
Fall 2023 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.

Student Request for Medical Withdrawal (PDF)
Recommendation for Return to Campus (PDF)
Licensed Provider Recommendation for Medical Withdrawal (PDF)