Health Record Requirements
果酱视频’s Health and Counseling Center (HCC) provides primary medical care and counseling services for students. In order to provide appropriate healthcare and to comply with state laws and regulations, we need to obtain certain information from you. All of your health forms are available within the . You can access the SHP using the same name and password you use for IRIS. Most forms on the SHP are fillable online. You also have the option of providing hard copy forms; which may be printed, completed, and returned to the HCC by mail, fax (503-777-7209), uploading through the SHP, or uploading using File Robot. When sending these documents via File Robot, please send them to: . These items must be completed prior to the first day of classes in the fall. Please keep a copy of these forms for your records.
Provider Health Assessment Form - REQUIRED for some
A physical exam completed within the past 12 months by a licensed medical provider (MD, DO, ND, NP, PA) who is not a family member is requested. This form is recommended for all, but required for anyone with a medical condition that is currently active. Please print out the form from the (Forms > Required Health Forms > Provider Health Assessment Form), have it completed by your provider, and return it to the HCC by mail, fax, or SHP upload.
Health History Form - REQUIRED
Please complete the form online via the (Forms > Required Health Forms > New Student Health History).
Emergency Contact Form - REQUIRED
Please download and complete this form from the (Forms > Required Health Forms > Emergency Contact Form). Upload the form to the portal upon completion.
Tuberculosis (TB) Screening Questionnaire - REQUIRED
If you answer “yes” to any of the screening questions, you will need to consult with a medical provider to review your exposure risks and the possible need for a TB test. Any student with travel to or from the high-risk countries that are listed on the questionnaire will more than likely require testing.
Tuberculosis (TB) Test Verification - REQUIRED for some
This form is required if you had positive responses on the above questionnaire. You might require further testing and a blood test, and/or a medical consultation. Please download this form from the (Forms > Required Health Forms > TB Test Verification) and bring it (along with the Screening Questionnaire) to your medical provider. Upload the signed and completed document to the Student Health Portal. Please call us at 503-777-7281 if you have questions.