FormsPage address: http://www.mnsu.edu/shs/forms.html
Medical Records Release Forms
This form is used to transfer medical records to or from another clinic or invidual:
- Release of Information Form for General Requests
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:
- Release of Information Form for ADD / ADHD Records
- Release of Information Form for Depo Provera Records
Students under the age of 18 required parent/guardian consent to be seen at Student Health Services
The Immunization Record Required for Admission:
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 firstname.lastname@example.org. This information is required before you can register for the following semester at Minnesota State Mankato.
Information about Health Care Directives
Patient Registration Form
To expedite your check in process, please fill in and print out the Patient Registration Form before your appointment. Bring this completed form with you to your appointment.
For further information please call: 507-389-6276.