Privacy Practices and Consent Forms
Every UHS patient and client will be asked to sign a form permitting UHS to treat them and advising them of certain practices related to their care. This is a one-time permission that remains in force for any treatment received at UHS during their time as a student at UW-Madison.
UHS takes the medical and mental health record confidentiality very seriously. The links below detail federal and state laws governing the release of protected health information.
- Information and Consent Form for Students
- Frequently Asked Questions About Consent for Treatment Form [PDF]
- University Health Services Privacy Information for Students [PDF]
- UHS Statement of Confidentiality Regarding Sexual Violence
- Consent and Information Form for Non-Students
- Privacy Practices for Non-Students
- Notice of Privacy Practices for Non-Students
- Rights and Responsibilities
UHS medical and mental health records are protected by federal law. UHS does not disclose information to parents or guardians for students over the age of 18 without the student’s consent. Students have the right to receive information about and assistance with advance directives and designating someone (known as a health care power of attorney) to make health care decisions for them in the event that they are unable. Being a Designated Agent for Advance Directives or Health Care Power of Attorney does not automatically allow access to medical records.