Forms
The following documents are in PDF format and require Adobe Reader, which is a free download.
- Research Initial Health Questionnaire
- Research Follow-up Health Questionnaire
- Research Allergy Screening
- Respirator Fit Test Medical Questionnaire
- TB Symptom Checklist
- Hepatits B Declination
Medical Release Forms
COVID-19 Forms
- COVID-19 Reporting Form: To be completed when an employee or student needs clearance for campus return.
- Requesting a Clearance to Return to Campus: To be completed when an employee or student needs clearance to return to the UTHSC campus. A clearance is provided when this form is signed by a University Health Services provider. Email this form to University Health Services at eohs@uthsc.edu.