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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Ut Prosim: Burton for Certain

Ray Burton ’62 lived all his years in the North Country of New Hampshire. Few elected officials have ever understood the lifestyle and character of their constituents as well as he did or have known so many of them by name. On December 14, 2013, hundreds of Burton’s fellow citizens joined dozens of past and […]

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Arts: Digital Repository Puts PSU’s History and Culture at Your Fingertips

Where can you get a close look at a photo of Babe Ruth standing in front of the Draper and Maynard Building, peruse a 1905 copy of Plymouth Normal School’s literary magazine The Prospect, and examine an aerial view of Plymouth State’s campus in 1960? Thanks to PSU’s digital repository, these historical treasures—along with 15,000 […]

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Wordsworth Meets Twitter: Teaching English in the Digital Age

Let’s face it: not all English majors aspire to a career in academia, so how do we help our students understand the role their English education plays in professional environments?