Forms

• Request for Medical Leave of Absence Requests are submitted electronically through the Student Wellness department.  If you're medical leave is being requested from a medical provider outside of the USD Student Wellness department please fax your medical records to The Student Health Center at (619) 260-2375 fax.  Once your medical records are received your request will be reviewed.
• Returning from a Medical Leave of Absence Form
• Authorization to Release Patient Information
• Consent to Receive Services Form 
• Parental Consent to Receive Services for Minors Form 
• Health History Form is completed through the MyWellness portal.

Submit your completed forms to via fax or email to: 

Fax to (619) 260-2375  usdhealthcenter@sandiego.edu (not secure or preferred)