Please click the statement that best describes the type of forms you are looking for.  All forms are in PDF format, unless otherwise stated, and may be downloaded.  If you are downloading a form because it is required for an appointment, please fill it out and return it to the Wellness Center prior to your appointment.

I need forms for:

New Students Attending Sewanee for the 1st Time

The University Wellness Center's HIPAA Notice (CAPS and UHS)

A Health Service Appointment

Information on Health Care for a Diagnosis I Have Received at Health Service

A Student Accessibility Service Appointment or Accommodations Request

A Counseling Appointment

Student Referral (For Local Therapists)

 

 

New students attending Sewanee for the 1st time will need:

  • New Student Forms 2017 - this form must be completed and returned to the Wellness Center by all Freshmen and transfer students (Freshmen should have access to this form via their Applicant Status Page).  This form is for students entering the University in the 2017-2018 year.  Please be sure to use
    your Portal to make sure your information is properly received.
   
The University Wellness Center's HIPAA notices (CAPS and UHS):

  • UWC HIPAA Notice and Privacy Statement
    this document contains information on the Health Insurance Portability and Accountability Act for Counseling & Psychological Services and University Health Service.  Every student utilizing CAPS and UHS is required to complete this form annually.
   
Students attending a Health Service (UHS) appointment will need:

  • UHS Treatment Consent Form‌ - students must complete this form prior to receiving services at University Health Service.  Every student utilizing UHS must complete this form annually.
   
Information handouts on health care for a diagnosis I have received at Health Service (UHS): 

   
Students wanting to apply for accommodations with Student Accessibility Services (SAS) appointment or submitting an accommodations request:

  • Consent for SAS Review
    Required - for students seeking
    any form of accommodations. 
    This form has been pre-filled out;
    you need only add your name, 
    address, dob at the top and your
    signature and the date at the bottom.
  • Consent for Residential Life 
    Required - for students seeking
    housing accommodations.
    This form has been pre-filled out;
    you need only add your name, 
    address, dob at the top and your
    signature and the date at the bottom.
  • Consent for Dean
    Required - for students seeking
    academic form of accommodations.
    This form has been pre-filled out;
    you need only add your name, 
    address, dob at the top and your
    signature and the date at the bottom. 
  • Consent for Sewanee Police
    Required - for students seeking
    parking accommodations.
    This form has been pre-filled out;
    you need only add your name, 
    address, dob at the top and your
    signature and the date at the bottom.
 
   
Students attending a Counseling or Psychological Service (CAPS) appointment will need:

   
  • CAPS Schedule Form
    Recommended - the schedule form is
    a way to let us know ahead of time when
    you might be free for an appointment.‌
 
   
Student Referral Forms for Local Therapists only 

 

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Please check back as we will be adding more forms and informational sheets in the future.