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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Nora Galvin ’14, Stellar Student-Athlete

As an NCAA Division III school, Plymouth State is home to the true student-athlete: the student who exhibits the same drive, dedication, and commitment to excellence both in and out of the classroom; who studies hard for a rewarding future; and plays for the love of the game. PSU social work major Nora Galvin ’14, […]

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Student Spotlight: Mae Williams ’14G A Twenty-first-century Preservationist

When Mae Williams ’14G enrolled in the Master of Arts in Historic Preservation program in the fall of 2012, she was drawn to the strength of a program in which, she says, “The professors are not academics locked away amidst a pile of books, but are actually out in the field on a daily basis, […]