COVID-19 Symptom Attestation

Online Forms

You will need Adobe Acrobat Reader to view PDF files. Download it for free.

Measles Forms

Measles Immunity Report Form
Measles Waiver Form
Summer MMR Waiver

Consent To Release Information

Release of Medical Records

(Complete form, print it, sign it, and send a picture of it to student.health@wwu.edu)

Consent To Obtain Information

Request for Medical Records

(Complete form, print it, sign it, and send a picture of it to student.health@wwu.edu)

Authorization to Treat Minors (under 18 years of Age)

Authorization to Treat Minors

Authorization to Manually Bill the Health Services Fee (when fee wasn't automatically billed to your WWU student account)

Authorization to Bill Health Services Fee

(Complete form, print it, sign it, and send a picture of it to student.health@wwu.edu)

Request to WWU Student Health Center to Receive and Store Medication

We can assist you in receiving and storing medications that need to be shipped directly to a health care facility. If you have a medication that needs to be shipped directly to a health care facility, and you wish to have the medication shipped to the Student Health Center, you must complete a request form (link is below). Only medications that are approved will be stored at SHC.

Request to WWU Student Health Center to Receive and Store Medication

(Complete form, print it, sign it, and upload the signed copy via MyWesternHealth (preferred) or FAX 360-650-3883)

Financial Hardship Waiver

If you are unable to pay the Health Services fee due to a financial hardship, you may request a waiver. Email your request to student.health@wwu.edu.

Send Completed Records to:

WWU Student Health Center
516 High Street, MS 9132
Bellingham, WA 98225
Fax: 360.650.3883
Please note this email address is neither encrypted nor secure.  There is a potential risk your information could be accessed or viewed by unintended eyes.  If you are concerned about your Personal Health Information fax the information to us instead.