STUDENT HEALTH CENTER (UPTOWN)
Campus Emergency Information | Student Health Center Staff | Downtown Student Health |
Insurance Information | Immunization Information | Self-Care | After Hours Contact | Health Promotion
Contact the:
Director
WebManager
Customer Service Rep
Last Updated:
June 12, 2008 10:19:16 AM
Mailing Address:
Student Health Center (Uptown)
Tulane University
6823 St. Charles, Ave.
Building 92
New Orleans, LA 70118
- Immunization Forms
New
Student Letter
Proof of Immunization Form
(please print and complete)
Meningococcal Disease
Information
Proof
of Immunization Form
(School of Public Health and Tropical Medicine)
- Medical Forms
Authorization for
Treatment of Minor (please print and complete)
Consent for the Release of Confidential Information
(please print and complete)
-
Women's Health Forms
Initial Women's
Health History Form (please print and complete)
DMPA Injection Student Questionnaire
(please print and complete)
Depo-Provera Consent Form
(please print and complete)
Birth Control Refill Questionnaire
(please print and complete)
Gardasil
Patient Information
Gardasil Vaccine Informed Consent Form
(please print and complete)
Patient Visit Assessment Form
(please print and complete)
- Other Forms
Travel Clinic Form
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