Download Forms

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1. Measles and Mumps Requirement Form
   Domestic students, you will need to complete the form and submit it to the Center for Student Health and Counseling for processing.

2. International Student Measles and Mumps Requirement Form
   If you are an international student, please complete this form and submit it to the Center for Student Health and Counseling for processing.

3. Authorization of Release
   Please complete this form if you need to authorize your medical and/or mental health records to be released or discussed with an outside provider. Records are released free of charge from provider to provider for continued care. If records are requested to be released to the individual there will be a fee based on the complexity of preparation. This fee will be billed to the student's account.

For information on submitting a claim visit: http://www.pdx.edu/shac/insurance-claims.