Health Forms

Unless otherwise noted, all forms are available as PDF. If you do not have Adobe Reader 9 installed, click OK on the error message to open form and download.

  • Health Questionnaire: Return this completed form to Health Services before your first appointment.  This form is not the one to be used for athletic participation.
  • Health Record Release: We must have this form on record if you need your records sent out or received.
  • College Screening Questionnaire: Return this form prior to mental health screenings (including depression, ADD, or ADHD screening).
  • Gynecological Health Questionnaire: Return this form prior to gynecological health appointments (for female patients).
  • STD Questionnaire: Complete this form before calling to make an appointment if you want to have STD testing done through Health Services.

In Plymouth Magazine

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PSU Collaboration Leads to Emmy

When Trish Lindberg was a 17-year-old musician, artist, and actor, her mother—a teacher herself—told her she would make a great teacher. Lindberg looked her mother right in the eye and said, “I will never be a teacher!” Mother Knows Best Decades later, Lindberg, now a Carnegie Foundation NH Professor of the Year, a recipient of […]

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Teaming Up for Service

There’s more to PSU’s student-athletes than excellent grades and athletic prowess. There’s a desire to make a difference in the world. Plymouth State men’s hockey coach Craig Russell ’09 encourages his team to serve as often as possible. Through the nonprofit organization Team IMPACT, which pairs children with life-threatening or chronic illness with local college […]