Patient Forms

Please bring your student ID and complete the following forms* when visiting the Student Health Clinic.

• Patient Consent Form [pdf]
• Health History Form [pdf]
• Adult Registration Form [pdf] (Only when needed for counseling appointments)

* The forms will open in a new window and are pdf documents.
If the forms do not open for you, download Adobe Reader to open the forms.

Student Health Office

Grundy Hall Rm 215
319-296-4224
studenthealthcenter@hawkeyecollege.edu