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CHS Medical Release of Information Form - **Please note we cannot accept an electronic signature on Release of Information forms, all forms must have an original signature before the request can be processed.  Requests for your records can take between 7-10 business days to process.  If you only need copies of your immunization records, you can pick up those records same day by visiting the Health Information Management Department located on the first floor of the building.

Initial Physical Form (to be filled out for your initial appointment with CHS)

Interim Physical Form (to be filled out annually after the initial Health History Form above has been completed)

IUD/Implant Insurance Form (Please call you  insurance company to determine benefits.  If you need assistance, please email insurancerep@unc.edu or call 919-966-6588)

Student Athlete Tryout Form

Travel Questionnaire

Request for Injection Allergy Therapy by Outside Provider Form

The required Immunization and Health History Form for incoming students can found on the Connect Carolina home page, under the More Student Links tab at the top of the page. Learn more at Immunizations or open the Immunization and Health History Form Instructions.