Patient Forms and Policies
Medical Records
All information is considered confidential and will not be released without the patient's
written consent or a signed court order. The Student Health Center retains medical
records for 10 years past the last date on which the service was given (22 TAC §§
165).
Authorization to Treat Minor Consent
The following consent forms must be completed by a parent or legal guardian for UH
students under the age of 18 before an appointment can be scheduled.
Medical Excuse Note Policy
The Student Health Center medical excuse policy is consistent with recommendations
from the American College Health Association and the policies of our peer institutions.
It also reflects our commitment to maintaining patient confidentiality, teaching students
how to use healthcare resources appropriately, and supporting meaningful dialogue
between students and faculty or their employer.
Department Billing
UHD departments may request that Faculty, Staff, or Students receive their Hepatitis
B Immunizations, Hepatitis B Titers, TB Skin Test, or QuantiFERON (QFT) test at the
Student Health Center. The charges for these services will be billed directly to the
department.
Notice of Privacy Practices
The UHD Student Health Center (SHC) is committed to preserving the privacy of your
health information. We are required by HIPAA (the Health Insurance Portability and
Accountability Act of 1996) to ensure the privacy of your protected health information
("PHI"), and to provide you with this notice explaining when and under what conditions
we may use or disclose your medical information, and what rights you have with respect
to your PHI. Your PHI is contained in a medical record that is the physical property
of SHC. Acknowledgment of the Notice of Privacy Practices is obtained electronically
through the Gator Health Portal.
Patient's Rights and Responsibilities
As a patient of the UH Student Health Center or any other healthcare facility, you
have certain rights, including the right to privacy, respect, professionalism, and
competent medical care. You also carry certain responsibilities to help optimize the
care you receive.
Consent to Treat and Health Care Agreement
The UH Student Health Center is an integrated healthcare facility providing medical
and mental health services. Acknowledgment of the Consent to Treat and Telemedicine
Informed Consent is obtained electronically through the Healthy Coog Patient Portal.
Appointment No Show/Late Arrival/Late Cancellation Policy
Appointment No Shows, Late Arrivals and Late Cancellations penalize patients who have
to wait for an appointment with one of our clinics. It could even force a patient
to seek care outside the Student Health Center costing them more than our services
in-house.