University Health ServicesUniversity of CincinnatiUniversity Health Services

University Health Services

Medical Forms

Health Insurance Portability and Accountability Act

Permission to Release Medical Information

Under Age 18

Annual TB Screening

Positive PPD Assessment Survey – for use with initial documentation of +PPD.
(VIS) Vaccine Information Statement for Influenza Vaccine 2013-2014

2013-14 Flu shot

2013-2014 Flu Mist

2013 - 2014 UHS Flu Form

Specialty Forms for Incoming Students

Initial Athletic Health Appraisal

Incoming International Student Health Form

Employee Occupational Health Forms

University of Cincinnati Initial Report on Occupational/Work-Related Injury or Illness

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    On-Line Form

1352a Initial Report on Work Related Injury or Illness

Appendix D – Respirator Medical Evaluation


New Employee – Supervisor Checklist

Employee Request for Reasonable Accommodation (ADA)