Forms / Policies
Student Wellness Services does not provide documentation for disability accommodations, emotional support animals, housing, or dining exceptions. Practitioners are able to provide referrals to off-campus providers for neuropsychological assessment, psychoeducational evaluations, or other documentation needs. Student Wellness Services providers can consult with an assessor or off-campus provider (with a signed release of information) if the student has been in treatment or the provider has information to contribute to the evaluation and documentation process.
All visits to the Health Center are confidential.
Our staff maintains strict confidentiality with your medical records at all times. Medical records of all patients seen at the student health center are retained for 7 years after the last patient visit. Medical records are not transferred to micro fische.
Rights and Responsibilities
- Notice of Privacy Practices
- Patient/Client Rights and Responsibilities (PDF)
- Release of Information and Records Consent Form (PDF)
- Medical Leave - Community Provider Report Form (PDF)
- NCAA Pre-Participation Forms (PDF)
- United Healthcare Prescription Drug Mail-In Order Form (PDF)
- United Healthcare Prescription Reimbursement Request Form (PDF)
- United Healthcare Medical Claim Form (PDF)
- Health forms for incoming students: Please click here to view the health form requirements and instructions. The deadline for completing the health forms is August 15, 2019
Student Wellness Services does not routinely provide medical excuse notes or visit verification for students who miss class or assignments due to minor illnesses or injury. Students experiencing illness or other health conditions are encouraged to seek treatment at Student Wellness Services, where the illness or injury can be assessed and treated. If a student is moderately to severely ill, contagious, or is otherwise advised to avoid class, a clinician may, with student permission, communicate this to the deans’ office. The deans may assist students by supporting academic accommodations or extensions; see the deans’ office website for relevant policies around academic extensions for medical reasons.
Students experiencing minor illnesses, allergies, and injuries are encouraged to directly contact their instructors or teaching assistants and request any extensions or flexibility with coursework.
In the event a student experiences an ongoing health concern that impacts their academic ineligibility, Student Wellness Services clinicians may, with student permission, consult with the deans’ office for the purposes of medical incomplete grades or a voluntary medical leave. Students who have not been under the care of a Student Wellness Services clinician or who present with only a historical account of illness or health concern will not receive a recommendation from Student Wellness Services.
Student Wellness Services does not perform clinical assessment, diagnosis, or documentation for disabilities. Students who wish to pursue academic accommodations for a disability are encouraged to contact Caltech Accessibility Services for Students (CASS) to learn about registration and requirements. Student Wellness Services can provide referrals to appropriate clinicians in the community, if desired.