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What is the Information and Consent Form?

If you’re checking in at UHS for a medical or mental health counseling visit for the first time this year, you will be asked to sign a new Information and Consent Form (either on paper or electronically). The form only has to be signed once. It will remain in effect for all your subsequent care at UHS unless you revoke it.

In summary, this form states that:

  1. You give UHS permission to treat you.
  2. You give UHS permission to share information with other health care providers, if needed for your diagnosis and treatment—for instance, to communicate with a specialist about your radiological images (“x-rays”).
  3. While there is no charge for most UHS services, there is a charge for some services not covered by the Student Health Fee. If a service involves a fee, you will be informed of that prior to receiving such service. You will be billed for such services, and you will responsible for paying those bills.
  4. Your provider may send you important health information, such as lab test results, through MyUHS using the “secure messaging” feature. You should sign up for MyUHS so you can collect these important messages.