Forms

All required forms can be found on your Medicat Patient Portal which is accessed through your WOU student portal. Many of the forms are fillable and will automatically upload into your electronic health record.

Required Documents Prior to Attending WOU:

All incoming domestic students must submit a Health History form and immunization records (specifically for MMR vaccinations). This information is required by law and/or mandated by WOU for students to attend WOU. Failure to provide this information will result in a registration hold.

Health History Form – printable version

Health History Form – fillable version (download to complete form)

Other Forms:

ROI – Release of Information form. To be completed if a student requests records to be released TO or FROM SHCC.

Western Oregon University’s Land Acknowledgement
Western Oregon University in Monmouth, OR is located within the traditional homelands of the Luckiamute Band of Kalapuya. Following the Willamette Valley Treaty of 1855 (Kalapuya etc. Treaty), Kalapuya people were forcibly removed to reservations in Western Oregon. Today, living descendants of these people are a part of the Confederated Tribes of Grand Ronde Community of Oregon and the Confederated Tribes of the Siletz Indians.

Accessibility Public Records Privacy Student Consumer Information

WOU prohibits discrimination on the basis of race, color, sex, national or ethnic origin, age, religion, marital status, disability, veteran status, sexual orientation, gender identity, and gender expression in all programs, activities and employment practices as required by Title IX, other applicable laws, and policies. Retaliation is prohibited by WOU.

Forms

All required forms can be found on your Medicat Patient Portal which is accessed through your WOU student portal. Many of the forms are fillable and will automatically upload into your electronic health record.

Required Documents Prior to Attending WOU:

Tools

Resources