Forms

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The following forms are available for download in PDF format. You must have a PDF viewer installed on your device before you can view & print these forms. We recommend using Adobe Acrobat Reader.  

 Asthma History Form
 Authorization and Consent for Treatment of Minors
 Authorization for Disclosure of Confidential Health Information
 Diabetes History Form
 Did Not Keep Appointment (DNKA) form
 Immunization History Form  (This immunization form, or comparable immunization records, is required of all incoming students.)
 Nutrition Information Questionnaire
 Travel History Form
 Women's Health Patient Questionnaire

Optional Disclosure of Private Mental Health Information​​

In compliance with the Student Optional Disclosure of Private Mental Health Act, the university has established procedures for students to have the opportunity to authorize, in writing, the disclosure of certain private mental health information to a designated person. Access to this information will be provided only to qualified examiners.  To make such a disclosure, please click on the above link.

Many of the above forms may be uploaded to MyMcKinley. Check here for information on MyMcKinley.

If you download and print these forms, please:

  • Please print forms longer than one page on both sides of the sheet.
  • Complete the forms in black ink.
  • Bring the completed forms to your appointment.