Please click the statement that best describes the type of forms you are looking for.  All forms are in PDF format, unless otherwise stated, and may be downloaded.  If you are downloading a form because it is required for an appointment, please fill it out and return it to the Wellness Center prior to your appointment.

I need forms for:

New Students Attending Sewanee for the 1st Time

The University Wellness Center's HIPAA Notice (CAPS and UHS)

A Health Service Appointment

Information on Health Care for a Diagnosis I Have Received at Health Service

A Counseling Appointment

Student Referral (For Local Therapists)

 

 

New students attending Sewanee for the 1st time will need:

  • This form must be completed and returned to the Wellness Center by all Freshmen and transfer students (Freshmen should have access to this form via their Applicant Status Page).  This form is for students entering the University in the 2019-2020 year and is available on your Portal
   
The University Wellness Center's HIPAA notices (CAPS and UHS):

  • UWC HIPAA Notice and Privacy Statement
    this document contains information on the Health Insurance Portability and Accountability Act for Counseling & Psychological Services and University Health Service.  Every student utilizing CAPS and UHS is required to complete this form annually.
   
Students attending a Health Service (UHS) appointment will need:

  • UHS Treatment Consent Form - students must complete this form prior to receiving services at University Health Service.  Every student utilizing UHS must complete this form annually.
   
Information handouts on health care for a diagnosis I have received at Health Service (UHS): 

   
   
Students attending a Counseling or Psychological Service (CAPS) appointment will need:

   
  • CAPS Schedule Form
    Recommended - the schedule form is
    a way to let us know ahead of time when
    you might be free for an appointment.‌
 
   
Student Referral Forms for Local Therapists only 

 

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Please check back as we will be adding more forms and informational sheets in the future.