Syracuse UniversityHealth Services

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Forms

Please contact Health Services at 315.443.9001 if you have questions on any of our forms.

Medical Transport Request Form

Health Services will provide temporary medical transportatoin to students for appropriate medical conditions. If you are in need of this service, complete this form and return it to Syracuse University Ambulance in Suite #006, Lyman Hall or fax to 315.443.3925. In addition to medical transportation, the quad shuttle service is a free service available to all students. For additional information on the quad shuttle, contact Parking & Transit Services at 315.443.4652 or visit their website.

Authorization for the Release of Treatment Records (Medical Records Release)

Health Services will release your treatment records or discuss your health information with a designated organization or individual upon completing this form.

Permission for Health Care of a Minor

This form is required for students under the age of 18 at the time of arrival on campus and must be completed by a parent or guardian.