Apply Today

Forms

Medical History Form: needed for your chart at your initial office visit. You may fill it out in advance and bring it to your first appointment.

Immunization Record Form: used to document your immunizations or to review SFA’s vaccination requirements. Your record does not have to be submitted on this form.

Allergen Injection Consent Form:  only applies to the students who will have their allergy shots given at the SFA Health Services.  Please read the Allergen Injection Policy first.

Medical Release Form:  used to request that your medical provider(s) send your medical records to SFA Health Services.

SFASU Authorization for Release Form:  authorizes SFA Health Services to send your medical records to another medical provider(s) at your request.

Consent to Treat Minor Student Patient:  applies only to students under the age of 18.

 

Mailing Address: Box 13058 SFA Station Nacogdoches, TX 75962-3058
Physical Address: On the S.E. corner of Raguet and East College Streets
Phone: (936) 468-4008 Fax: (936) 468-1316
Email: healthservices@sfasu.edu
Hours of Operation: Monday - Friday 8:00a.m. - 5:00p.m.
Dr. Appointments: 8:30 a.m. - 11:30 a.m. and 1 p.m. - 4:30 p.m.

Top of page

Become a Student Academics & Research Students Alumni & Friends Faculty & Staff Arts & Athletics A-Z List