Student Health Services Forms
Patient Registration Form
If you are a new patient at Student Health Services, please visit the Patient Portal and complete the Patient Registration Form before your first appointment. For further information, please call: 507-389-6276.
Releasing Your Medical Records
To get a copy of your medical records released to or from another clinic or individual, please print and complete the Authorization of Disclosure of Health Information Medical Records Release Form and return it to Student Health Services in person or by Fax 507-389-5787.
If you need a specialized medical record release form, such as ADHD or women's health records, please contact or stop into Student Health Services.
Students under the age of 18 require parent/guardian consent to be seen at Student Health Services. Please print and complete the Minor Consent Form and return it to Student Health Services in person, by email at healthservices@mnsu.edu, or by fax 507-389-5787
