Forms

Georgia Southern Health Services requires various forms to be completed upon enrollment and prior to your visit with one of our providers. In addition to being available below, many of these forms are listed on the Forms tab of your Eagle OSH (Online Student Health) portal in MyGeorgiaSouthern.

Some specialty clinics, like Eagle Eye and Physical Therapy, may have additional forms that will be provided to you prior to services.

Completed forms can be uploaded to your Eagle OSH Patient Portal.

Required Forms

• Certificate of Immunization
• TB Screening Questionnaire (Eagle OSH – Forms)

Parental Consent (for ages 17 and under)

• Authorization to Treat (Parental Consent)

Release of Information

• Consent to Release Information – General Clinic
• Consent to Release Information – ADD/ADHD
• Consent to Release Information – Psychiatry Clinic

Additional Forms

• Xolair Injection Guidelines and Agreement Form
• Allergy Immunotherapy Guidelines

Last updated: 5/17/2023