Forms & Documents

Required for Registration

Immunization Form

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

 

 

Patient Forms

Authorization Form

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.

Authorization for Use or Disclosure of Protected Health Information

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 877-592-8688
    • 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
 Last Modified 10/16/17