Patient Forms
Health History Forms
In compliance with state law, the University of Richmond requires all entering full-time students to provide documentation relative to their health and immunizations.
As a matter of policy, the Student Health Center requires non-UR students residing in University housing for more than one month to comply with state law regarding documentation of required immunizations. Contact the SHC for more information.
- Health History Record - Undergrad/Transfer students
- Health History Record - Exchange Students
- Health History Record - Law and Grad Students
- Health History Record - Bridge to Success - Due June 1, 2012.
Authorization for Release of Medical Information
Before releasing your medical information to any third party, we must have a completed Authorization for Release of Medical Information. For more information about this form, see Medical Records and Patient Confidentiality.