Required Forms

Every newly admitted student must complete and submit the following forms before attending orientation:

1. Your Health History form

Gather your personal health history information and medication records. Complete the online health history. Enter the information carefully and only hit the “submit” button once.

2. Immunization Packet
(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

Immunizations Packet: Certificate of Immunization Form and Tuberculosis (TB) Screening Form
(These forms are in PDF format. You must have Adobe Reader in order to view and print. Download Adobe Reader.)
It is OK to submit GRITS or other certified immunization record.

*Transfer Students
Please be aware that your transcripts will not contain your immunization records.  Please send a copy of your immunization records from either your university/college or from your physician.  The UGA TB screening form must also be completed and returned before you can register for class.

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)

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

More info on Confidentiality and Patients’ Rights and Responsibilities

Attention students 17 years old or younger:
Please download and print 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 the printed and signed form 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

4. Insurance Information Form

Insurance Form - to be completed by parent / guardian

More info on Costs and Health Fee

Upload: (Recommended method)
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: