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Student Health Forms

Find forms for immunization records, release of information and a TB questionnaire within the list of available options from Student Health Services.

We typically do not track online programs, if you don't see your program listed on any of the immunization record forms listed below, please contact your program director.

The following is a consolidated list of Student Health Service forms as PDF files:

The completed and signed forms along with immunization documentation and lab reports may be submitted by:

  • mail to KUMC Student Health, 1012 Student Center, MS 4044, 3901 Rainbow Blvd., Kansas City, KS  66160. 
  • email your information to or
  • fax your information to 913-588-1943
Office of Academic and Student Affairs

University of Kansas Medical Center
Student Health Services
Student Center, 1012
Mailstop 4044
Kansas City, KS 66160
Phone: 913-588-1941