Student Medical Report Form

This form is MANDATORY for all incoming students. Please submit this form to the health office prior to the deadline date. A failure to do so will result in an academic hold and the inability to register for classes. All information obtained from the student Medical Report Form is confidential and only viewed by the medical staff in the MyHealth Point Park office. The information in this document will not be released to anyone without consent. A consent to release medical information form must be signed by the student for the medical staff to speak with any other party about any medical care provided or any health history.



3rd Floor of the Student Center, 412-392-3800, studenthealth@pointpark.edu
If you would like to submit a physical copy of this form rather than complete it here, please download the form: Student Medical Report Form

Please mail all forms to MyHealth Point Park - 201 WOOD STREET PITTSBURGH, PA 15222, submit a PDF below or email in pdf to STUDENTHEALTH@POINTPARK.EDU
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