General Documents & Forms

Authorization Forms


Authorization for Release of Medical Information from FAU
Print a blank form and then complete the form by hand.

Deliver the form to Student Health Services via one of the following methods:

Fax a signed copy to (561) 297-0494.
 
Mail a signed copy to:
Florida Atlantic University
Student Health Services
777 Glades Road
Boca Raton, Fl 33431
 
Bring a signed copy to the Student Health Services office.

Authorization for Release of Information to FAU
To have your medical records sent to FAU, print and complete the form and provide it to the provider in possession of your records. Please allow sufficient time prior to your appointment for Student Health to receive your records.

Immunization Forms


See our Frequently Asked Immunization Questions for more information about Immunization requirements.
Immunization Form
Immunization FAQs

Medical Health History Form


Note: If you have never been seen before in our clinic, you will need to print and fill out the Medical History Form and sign the Release to Treat section on the second page. Bring the completed form to your appointment.
Medical Health History Form

Dental Clinic Health History Form


Click Here to Download Now!

The Dental Clinic Health History Form is available for download and printing in PDF Format only.

FAU Campuses: Boca Raton/Davie/Dania Beach/Fort Lauderdale/Jupiter/Treasure Coast Boca Raton Campus Danie Beach Campus Davie Campus Fort Lauderdale Campus Harbor Branch Campus Jupiter Campus Treasure Campus
 Last Modified 10/6/14