Below are some of the available forms for University Health Services.
Patient Rights and Responsibilities
Immunization Form
UO Certificate of Immunization Status
Dental Clinic Forms
University Health Services Dental Clinic Patient Registration Form
Consent to Bill Dental Insurance
Medical Records
Translated forms are provided for reference only. The English language versions must be used when submitting forms to health services.
- Release of Information–Arabic
- Release of Information–Chinese
- Release of Information–Japanese
- Release of Information–Korean
Notice of Privacy Practices (NPP)
- Notice of Privacy Practices–Arabic
- Notice of Privacy Practices–Chinese
- Notice of Privacy Practices–Japanese
- Notice of Privacy Practices–Korean
Informed Consent for Psychiatry Services
Travel Clinic Forms
Forms for Students Under 18 Years Old
UO Health Plan Enrollment—Domestic students
UO Health Plan Enrollment—International students