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Forms and Policies

The following forms are processed through Counseling and Health Services:  

Class excuse Policy

Within the guidelines of the MSU UAR 131.04 Excused Absence policy, the clinic will provide the students with written confirmation of treatment on a specific day. Please note, it is a statement that the student was seen at the clinic on a specific date and it is not an excuse slip according to the guidelines of the policy. These statements will be branded with the Counseling & Health Services embosser to prevent fraudulent documentation. The granting of an excused absence or any make-up work will be solely at the discretion of the professor.

Tobacco-Free Policy

Morehead State University is a tobacco-free campus, under MSU UAR 902.02 Designated Smoking Areas, effective July 2011. This policy applies to all students, faculty, staff, visitors, clients, contractors, and vendors. This policy is in effect at all times, twenty-four hours a day, seven days a week. This also includes University property outside the main campus such as farm facilities, golf courses, art galleries, parking lots, performance venues, and sporting venues, and functions that are held in these facilities and venues.

Authorization of Medical Information Disclosure and Access

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of services and care you receive at the clinic. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by the clinic, whether made by clinic personnel or your doctor. Your personal doctor may have different policies or notices regarding the doctor's use and disclosure of your medical information created in the doctor's office or clinic. This notice will tell you about the ways in which we may use and disclose medical information about you. View the full Authorization and Notice of Medical Information Disclosure and Access policy.

Immunization Policy and Fee Schedule

For completion of compliance, students shall enter immunization information in the Online Patient Portal. Original immunization documents are necessary for completion of compliance. These documents may be scanned and uploaded via the Online Patient Portal. The documents may also be brought in to the Counseling and Health Services if uploading of documents is not possible.  Documents will only be accepted in this manner (no fax copies) and with identification of medical facility and signature of medical provider on document(s). View the full immunization policy and fee schedule.  

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