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Student Health

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Visit the University of North Carolina at Charlotte homepage
Visit the University of North Carolina at Charlotte homepage

What can we help you find?

  • Academics
  • Admissions
  • Campus Life
  • Research
  • Athletics
  • About
  • Apply
  • Visit
  • Give
  • News & Events
  • Directory
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    • Calendar
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Student Health

  • Home
  • General Information
    • About Student Health
    • Meet Our Staff
    • Medical Records and Referrals
    • Forms & Resources
    • Frequently Asked Questions
  • Services & Appointments
    • Appointments
    • Medical
    • Pharmacy
  • Immunizations
    • Immunization Requirements
    • Available Vaccines & Tests
    • COVID and Flu Vaccine
    • Request Immunization Records
    • Travel Clinic
    • Allergy Clinic
  • Insurance & Charges
    • Insurance at Student Health
    • Student Blue Health Insurance
    • Fees, Charges & Payments
  • Events & Classes
    • Classes

Breadcrumb

  1. Home
  2. General Information
  3. Forms & Resources

Forms & Resources

  • Allergy Packet
  • Authorization to Release Healthcare Information 
    • You will be redirected to a DocuSign document. Fill out the form and sign electronically. Retain a copy for your records. We will receive your completed form once it has been submitted. 
  • Health History
    • Link will redirect you to the Patient Health Portal.
  • High Risk Countries for TB
    • See if you are required to have a TB skin test or TB blood test for entry to the university.
  • Insurance Terms to Know
  • Interpersonal Violence (IPV) Guide
    • If you or someone you know has been affected by Interpersonal Violence, such as sexual assault or relationship violence, help is available.
  • Notice of Privacy Practices (NPP)
  • Patient Financial Responsibility Form
    • A Patient Financial Responsibility Form is a required form for all Student Health patients. Click here to access this form under the Required Forms section on the My Niner Health Portal.
  • Patient Rights and Responsibilities
  • Self-Care Resources
    • Manage many illnesses and injuries safely and effectively from home. 
  • Urgent Care/Emergency Care Off-Campus

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Main Campus Address

9201 University City Blvd
Charlotte, NC 28223

The Dubois Center Address

320 East 9th Street
Charlotte, NC 28202

Phone

704-687-8622
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