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Please mail or FAX these forms. Do not email.

Mailing address: Univerity Health & Counseling Services, 800 W. Main Street, Whitewater, WI 53190

UHCS Medical Records FAX: 262-472-5608

UHCS Counseling Records FAX: 262-472-1435

Health Services Release of Information

Counseling Services Release of Information

Immunization Record

Chronic or Recurring Health Information

Allergy Injection Agreement

Group Screening Form

Reference Check Form

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For health care questions, do not email, please call 262-472-1300 menu option 4

UW Whitewater University Health & Counseling Services
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