Health history & immunization forms

The State of Oregon and Oregon State University require the submission of a completed health history form and proof of specific vaccinations, or proof of immunity. Please download the form that applies to you below, complete it electronically and fax it to Student Health Services at 541-737-9665. The form can also be mailed. Please mail the completed form to: Student Health Services, Attn: Immunizations Office, 108 SW Memorial Place, Corvallis OR 97331. This form is also available on the Patient Portal.

Student health history form (PDF)

International student health history 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 (Word doc).

College of Veterinary Medicine Health History Form (Word doc)


Medical record Release of Information form

You may receive a copy of your records, or you may have a copy forwarded to your personal healthcare provider, by completing the Consent/Authorization to Disclose Medical Records form. 

Consent/Authorization to Disclose Medical Records form (PDF)



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. If there are any questions about this form, please contact Medical Records.

Advance Directive Form (PDF)