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Health Services Forms and Documents

Health Physical Form
For full time students
Pages 1-2 (Student)
Pages 3-4 (Clinician)

Immunization Form
For part time students

Immunization Request Form
For students who are graduating or who leave the university and want to request their medical records. Please allow up to two weeks for requested records to be sent. State law requires that the university keep medical files for a period of seven years after a student has left the institution. After that time period, all records are destroyed. Please contact Health Services for further information regarding your medical records.

Patient Financial Responsibility Notice
For all students.
This notice details the financial responsibility students bear for the health care they receive at and/or through Health Services at UNH. Please note: This notice is provided here for your information and review. You do not need to download and return this form now - students will be asked to sign this form at the time they utilize Health Services.

Emergencies and After Hours Care
Click here for a printable list of care centers.