Forms
Medical Record Requests Sent from Union
Union University holds clinic health records on all university students for ten years. If you need a copy of your record, we must have the release of information form filled out and faxed back to us at 731.661.5499. Upon receiving the release of information form, please allow two business days to process.
Medical Record Requests Sent to Union
If you need a copy of your medical record sent to Union, please send this release of information form to your healthcare provider to facilitate this request.
Health History
Please fill out this form prior to your visit to the Health Clinic to avoid having to fill it out in the lobby.
Vaccination/Immunization Forms
The Tennessee Department of Health has immunization requirements for those who attend college. In compliance with this law, and in an attempt to maintain a safe and healthy campus environment for our students, faculty, and staff, Union University requires that all entering students provide documented proof of having immunity or having been immunized for MMR, Varicella, and Meningitis ACYW unless medically contraindicated.
Allergy Injection Policy
The Student Health Clinic will administer allergy injections to Union students with the following provision on file:
- Written orders from your allergist who has provided the appropriate serum.
- Your signature on the allergy injection policy form.
- If student, must be enrolled in current semester.
Psychostimulant Medications
If you have been prescribed a psychostimulant medication for the treatment of ADD, ADHD or other condition, the Student Health Clinic can administer your medication by filling out this form.
Equipment Rentals
For injuries such as sprains, strains, and fractures, we offer crutches and wheelchairs for loan through our Health Center. An agreement is signed with a due date and charges are made to students' account if an item is not returned on time or in good condition.