Washington State University

Health and Wellness Services

Downloadable Forms

For your conveinence, many of our forms are available to view online. To expediate appointment check-in you can also print and complete any necessary forms prior to your visit. Adobe Acrobat reader is required to view the below forms.

Clinical History Forms
Health History
(Submit online through the Health Web)

Measles/Immunization
Arabic Translation
Chinese Translation
Indonesian Translation
Japanese Translation
Korean Translation
Spanish Translation
Vietnamese Translation

Authorizations
Consent to Release/Obtain Health Information
Treatment Authorization for Minors
Health Fee Petition
Photo/Video/Audio Policy & Consent

Privacy & Patient Rights
Privacy Policy
Patient Rights & Responsibilities

Graduate/Professional Student PASS Program
PASS Enrollment
PASS Cancellation

Health & Wellness Services, PO Box 642302, Washington State University, Pullman WA 99164-2302,
P 509-335-3575, F 509-335-6223, hws@wsu.eduPatient Rights