Medical Forms

Requests for Medical Records

Students may request copies of their medical records housed at University Health Service by submitting a Medical Information Request Form. This form is needed for any records release and can be downloaded from the link below.

REQUESTS FOR MEDICAL FORM COMPLETION

Students that need to have a form reviewed, completed, and signed by their medical provider should submit a request as follows:

Complete the demographic information on your form and as much of the immunization information as possible. Use your immunization information found at: MyHealthConnect.case.edu on your "Immunizations" page. Click on the "Show Details" tab on the right side of this page to obtain details about immunizations or TB data.

Next, submit your form using the following method:

  • Log on to MyHealthConnect.case.edu
  • Click on "Message" option in the menu; then "New Message".
  • Click "I want to send a form to be signed or completed".
  • Choose M-R (for N, Nurse, Immunization) for Recipient; fill in Subject and note and upload the form.

Within three to five days, a clinician will send you a secure message. This will include a completed form, if possible, or instructions on actions needed from you to finish the form. A copy of the form will be filed in the your Electronic Health Record.

NOTICE OF PRIVACY PRACTICES

This notice describes how health information about you may be used and disclosed and how you can get access to this information. Students are requested that they review and acknowledge receiving the Notice of Privacy Practices within the MyHealthConnect site

For Staff