Forms and Downloads
- Authorization for Use and Disclosure of Protected Health Information Form
- Health History/Immunization Form
Every student entering a South Carolina college or university is required to provide an immunization record. A copy of your immunization record must be provided prior to your enrollment. Please complete the Health History/Immunization Form and return it to Student Health Services. If you have any questions regarding immunization requirements, please call Student Health Services at 843-349-6543 or fax medical records to 843-349-6546.
- Immunization Exemption Form (Medical)
- Immunization Exemption Form (Religious)
- Notice of Privacy Practices
- Patients Rights and Responsibilities
- SHS Brochure
Location
204 University Boulevard
Across the street from Baxley Hall
(east side of University Blvd)
click on map below
Mailing Address
Student Health Services
Coastal Carolina University
204 University Boulevard
Conway, South Carolina 29526
Telephone: 843-349-6543
Facsimile: 843-349-6546
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