Health Forms

Required Forms for Students

Before attending classes, all Appalachian State University students must submit a "Immunization Record" as required by University Policy and North Carolina law.

Prior to being seen in the Student Health Clinic a Medportal Health History form MUST be completed.

The deadline for incoming students to complete these requirements is Jan 1 for spring semester and July 1 for fall semester.  

We ask that students enter their immunizations via the MedPortal as well.  Immunization Records should then be uploaded via the MedPortal.

If you do not have access to a computer to accomplish this task, you may go to Student Health Service and they can assist you with this process by providing computer access.

Other Health Service Forms (use as needed)

To request a copy of your medical records and/or immunizations:

Mail a written request and a completed Release of Information Form to:

ASU Health Services
ATTN: Medical Records
PO Box 32070
Boone, NC 28608-2070

Include the following items in your written request:

  1. Full name at the time you were a student
  2. Student ID number (banner ID)
  3. Date of birth
  4. Date of last semester attending ASU
  5. Check made out to ASU Health Services in the amount of $5.00 (no charge for immunization records only)
  6. Written signature
  7. Address you wish to have the information mailed to
  8. Please include current contact number


Allergy Clinic Information and Forms:


Name Change Form


Withdrawal Checklist


Page content reviewed: 11/21/16 kal


Contact Us

Contact the Director

Miles Annas Building
PO Box 32070
614 Howard Street
Boone, North Carolina 28608

Main: (828) 262-3100
Appointments: (828) 262-6577
Insurance: (828) 262-7463
Medical Records: (828) 262-6578
Laboratory: (828) 262-6956

Fax: (828) 262-6958

Spring Clinic Hours:
Monday - Friday
(except Wednesday):
8:00 am - 4:00 pm
Wednesday: 9:00 am - 4:00 pm

Weekends:  Limited Services:
Saturday:  10am-2pm
Sunday:  1pm-5pm

Pharmacy is CLOSED on weekends and during Semester Breaks

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