Commonly Requested Forms
- Care Agreement*
- Financial Agreement*
- Privacy Practices*
- Power of Attorney (A durable power of attorney for health care is a legal document allowing you to name a person as your health care agent—someone who is authorized to consent to, stop or refuse most medical treatment for you if a physician determines you cannot make these decisions yourself. Complete the Durable Power Of Attorney Form and bring it with you to your next appointment so that it can be added to your electronic health record.)
- Pre-Registration Form (for new patients to Husky Health Center. Filling out this form prior to your first visit can save time.)
- The Travel Planning Questionnaire is for new patients to the Travel Clinic.
Print student name and student UW ID on form. Once complete, please bring the documents to your first appointment or email your signed documents to uwhhc@uw.edu
Minors: Parents/guardians of students and other patients who are minors (under 18) will need to sign the starred (*) forms above.