Required Forms

Every newly admitted student must complete the following forms:

1. Your Health History form

Gather your personal health history information and medication records. Complete the online health history when you arrive at UGA and before your first visit to the University Health Center. Enter the information carefully and only hit the “submit” button once.

2. Immunization forms
(including the Certificate of Immunization and the Tuberculosis Screening forms, and the additional Tuberculosis Risk Assessment form if you have risk for tuberculosis)

The Certificate of Immunization and TB Screening Forms below must be printed and completed fully before you can register for classes. Please submit all forms before you arrive to your orientation session. Your doctor must sign your Certificate of Immunization form. Please keep a copy of your immunizations for your records. More info on Required Immunizations

Certificate of Immunization Form
Tuberculosis (TB) Screening Form
(These forms are in PDF format. You must have Adobe Reader in order to view and print. Download Adobe Reader.)

Log in to UHC Patient Portal.
Select “Immunization Upload” from the left column.
Upload Immunizations and TB Screening Form.

Mail to:
Registration and Health Information
University Health Center
The University of Georgia
Athens, GA 30602-1755

Fax to:
706-542-4959 or 706-583-0777

Email to:

3. Patient Agreement form
(including statements giving permission to treat you, agreement to pay charges that you may incur, and understanding of your rights to privacy and to ask questions about your care and safety)

More info on Confidentiality and Patients’ Rights and Responsibilities

Click here to download the Patient Agreement Form. Read it, sign it, and send it in with your immunization form.

Attention students 17 years old or younger:
Please download the Patient Agreement Form and have your parents sign to give permission for the University Health Center to provide treatment. You must mail the form to the address listed at the top right-hand corner of the form, upload via UHC Patient Portal (select “Immunization Upload”), fax to the number listed below, or bring the signed form with you before you can be seen for an appointment. Parental signature on the form is required for students under the age of 18 to be treated at UHC. More info on your health records

Fill out other required forms using the UHC Patient Portal
*The UHC Patient Portal is a secure environment for entering your information.

4. University Health Center insurance form (if applicable)

More info on Costs and Health Fee

University Health Center Medical Insurance Form