Forms

Mailing address:
University Health & Counseling Services
800 W. Main Street
Whitewater, WI 53190
UHCS Medical Records FAX: 262-472-5608
UHCS Counseling Records FAX: 262-472-1435

Forms:

• Health Services Release of Information
• Counseling Services Release of Information
• Allergy Injection Agreement
• No Show Appeal Form
• Athlete Sports Physical forms - 2 parts (as required by UWW Athletic Dept); complete Medical Questionnaire form before clinic visit and bring to visit
  • Questionnaire
  • Physical Form

University Health and Counseling Services requests all incoming students fill out 5 online health forms prior to using clinical services.

• To complete these forms, go to our secure online system: https://uhcsportal.uww.edu/login_directory.aspx
• Login to MY UHCS with your campus assigned User Name and Password.
• After login, select "FORMS" from the left column to complete the 5 health forms

Got questions? Check out our web site ( http://www.uww.edu/uhcs/ ) or call 262-472-1300. We look forward to seeing you soon.

Last Updated: 02/12/16