- ABOUT SHS
- Clinic Services
- Allergy and Asthma
- Consulting Specialists
- Lab and X-ray
- Massage Therapy
- Medical Advice Nurse Line
- Men's/Women's Health
- Occupational Health
- Oregon Contraceptive Care
- Psychiatric Services
- Sexual Assault Nurse Examiner
- SHS @ Dixon
- Sports Medicine/Physical Therapy
- Travel Medicine
- Health Promotion
- Domestic Student Insurance Plan
- International Student Insurance Plan
- Graduate Assistant Insurance Plan
- Graduate Fellow Insurance Plan
- Postdoctoral Fellow Insurance Plan
- Postdoctoral Scholar Insurance Plan
- Students with Private Insurance
- ASOSU Insurance Subsidy
- Common Medical Insurance Terms
- Insurance Resources
- Clinic Services
- NEW STUDENTS
Health History and Immunization Forms
The State of Oregon and Oregon State University require the submission of a completed health history form and proof of 2 doses of MMR (measles, mumps, rubella). The preferred method for submitting the information is via the Patient Portal. If you are unable to use the Patient Portal you may print the form from the following link and fax it to Student Health Services at 541-737-9665.
Medical Record Release Form
You may receive a hard copy of your record at a cost per page or may have a copy forwarded without cost to your personal health care provider by completing the Authorization to Release Medical Information Form.
Request for Itemized Billing Statement
If you need a copy of your itemized billing statement, please complete this form and place it in any of the “Request for Itemized Billing” boxes conveniently located on the 2nd floor of the Student Health Center. Your billing statement will be mailed to you. This statement contains all the coding that is needed for your insurance company to process your claim. This bill will not reflect charges from the SHS Pharmacy (please request those statements directly from the Pharmacy).
Advance Directive Form
An advance directive is a set of instructions that explain the specific health care measures a person wants if he or she should have a terminal illness or injury and become incapable of indicating whether to continue curative and life-sustaining treatment, or to remove life support systems.
Advance Directive Form (PDF)
College of Veterinary Medicine Health History Form
Upon admission to OSU College of Veterinary Medicine, this form must be completed and submitted to receive medical clearance. This form is in addition to the general health history form you must complete before your first term at OSU, and is just one part of the required documentation for Veterinary Medicine students.
College of Veterinary Medicine Health History Form (fillable PDF)