On your first visit to Student Health Services you will be asked to complete a medical history form. Below is a link to the Health History Form.

Student Health Services Health History Form

You may print a copy of the form, complete the form, and bring it with you on your first visit to the Health Center or you may choose to mail your completed form to:

The University of Memphis
Student Health Services
200 Hudson Health Center
Memphis, Tennessee 38152

If you are under the age of 18, your parent or legal guardian must also sign your completed form.

Faxed copies of the completed form will not be accepted.