Two Clinic Locations:
LINDNER CLINIC | PHONE (West Campus): 513-556-2564
Medical Records Fax: 513-556-1337
HOLMES CLINIC | PHONE (East Campus): 513-584-4457
Medical Records Fax: 513-584-2222
Two Clinic Locations:
Tell Us How We Are Doing
Have you recently visited one of the UHS clinics?
Please take a moment to fill out our customer service survey.
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 2010-2011
2010-11 Flu shot
2010-11 Flu Mist
Specialty Forms for Incoming Students
Initial Athletic Health Appraisal
Incoming International Student Health Form
2012 - 2012 UHS Flu Form
Employee Occupational Health Forms
University of Cincinnati Initial Report on Occupational/Work-Related Injury or Illness
- This form currently works only with Internet Explorer on a PC
On-Line Form
1352a Initial Report on Work Related Injury or Illness
Download
Appendix D – Respirator Medical Evaluation
OHIO FROI
New Employee – Supervisor Checklist