Forms

Page address: https://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:

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

 

[PDF] Patient Health History Form / Payment Authorization Form (162 KiB)

Please complete this form prior to coming to your first appointment at Student Health Services.

 

The Immunization Record Required for Admission:

e-form (must have java) or fillable [PDF] pdf (77 KiB)

This form is required if you graduated high school from outside the state of Minnesota or before 1997. 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 healthservices@mnsu.edu. This information is required before you can register for the following semester at Minnesota State Mankato.

 

Health Care Directive Planning ToolKit

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