Plymouth State University
Health Services: Forms


 
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Health Questionnaire for incoming students - fill this form out if you are coming to the infirmary for the first time. (Mostly for 1st year students, if you have been there before you most likely have already filled this out)

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Permission to release and/or receive information - fill this form out if you may need your medical records sent out or received.

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College Screening Questionnaire - fill this form out if you are seeking mental health screening including depression & ADD/ADHD.

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Gynecological Health Form - fill this out (females) if you are coming to the Infirmary for gynecological reasons.

 

 
 
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Plymouth State University, 17 High Street, Plymouth, NH 03264-1595. Main Switchboard: (603) 535-5000.
A member of the University System of New Hampshire. ©2005-2008. All rights reserved.
This page was last revised: 12/12/2007