Forms

Consent for Release of Information

The Consent for Release of Information must be filled out for the center to release any protected health records, as stated in our Notice of Privacy Practices.

 

Consent for Treatment of a Minor

Students under the age of 18 need to have parents or legal representative fill out and return this form.

 

Health inventory and immunization records

All newly admitted students residing in student housing must complete the health inventory and immunization form before arriving on campus.

Students can update medical information and print copies of their immunizations in the Patient Portal: Patient Portal

Exemption forms

Please note: the form above is the only religious exemption form available through the State of Alaska and does not address adults or University students. This form only addresses K-12 schools, preschools and
child care facilities.