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Minnesota State University, Mankato
Minnesota State University, Mankato


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Medical Records Release Forms

This form is used to transfer medical records to or from another clinic or invidual:

Special information is requested on these forms to ensure we get the proper records to contrinue your medical care.  These forms are for records to be sent to Student Health Services from another facility:


Minor Consent for Treatment

Students under the age of 18 required parent/guardian consent to be seen at Student Health Services


The Immunization Record Required for Admission:

  • e-form (Note: Form does not consistently work with Firefox browser)
  • Fillable [PDF] pdf (77 KiB)

This form is required if you graduated high school from outside the state of Minnesota or from a Minnesota high school more than 10 years ago. You should have received information and a link to this form in your admitted student letter. You may submit the form electronically or send to Student Health Services, 21 Carkoski Commons, Mankato, MN 56001; fax (507) 389-5787; email This information is required before you can register for the following semester at Minnesota State Mankato.

 A Notary Public signature for students who complete Part 5 of this form is available at Student Health Services.

Information about Health Care Directives

Health Care Directive Planning ToolKit

Questions and Answers about Health Care Directives from the Minnesota Department of Health


Patient Registration Form

To expedite your check in process, please fill in and print out the [PDF] [PDF] Patient Registration Form (128 KiB) (107 KiB) before your appointment. Bring this completed form with you to your appointment.

For further information please call: 507-389-6276.