UGA PharmD STUDENT HEALTH REQUIREMENTS
Every newly admitted student must complete and submit the following forms before registering for classes
Please submit all required forms by the school-provided deadline and keep a copy for your records.
Log into the Patient Portal, then click on “Insurance Details” in the left navigation bar.
This can be downloaded HERE.
Immunization & Testing Packet
1. Download and print the form.
2. Please have a healthcare provider complete and sign the form. This can be a registered nurse, nurse practitioner, physician assistant, physician, pharmacist, Department of Public Health representative, etc (who is not a family member). Alternatively, a GRITS record or other certified immunization record may be provided for relevant immunizations. No signature is required on the certified record, if provided.
3. Upload a copy of the form and attach results of testing as indicated to the Patient Portal AND the College of Pharmacy's CORE ELMS database using the directions provided by the College.
4. Retain a copy of the submitted form(s).
1. Download and print the form.
2. Please have a healthcare provider complete and sign the form. This can be a registered nurse, nurse practitioner, physician assistant, physician, pharmacist, Department of Public Health representative, etc (who is not a family member). Alternatively, a GRITS record or other certified immunization record may be provided for relevant immunizations. No signature is required on the certified record, if provided.
3. Upload a copy of the form and attach results of testing as indicated to the Patient Portal AND the College of Pharmacy's CORE ELMS database using the directions provided by the College.
4. Retain a copy of the submitted form(s).
Healthcare Provider Attestation Form & Annual Health Form
All sections must be completed and verified by a licensed healthcare provider (MD, DO, NP, or PA) who is not a family member. Every newly admitted student must complete and submit these forms before registering for classes.
1. Download and print each of these forms.
2. Complete your portion of the Annual Health Form (pages 1-3).
3. Please have a medical provider (MD, DO, NP, or PA who is not a family member) complete and sign both forms.
4. Upload a copy of both forms to the Patient Portal. Not needed if completed at the UGA University Health Center.
5. Upload a copy of the Healthcare Provider Attestation Form ONLY to the College of Pharmacy's CORE ELMS database using the directions provided by the College.
6. Retain a copy of submitted form(s).
All sections must be completed and verified by a licensed healthcare provider (MD, DO, NP, or PA) who is not a family member. Every newly admitted student must complete and submit these forms before registering for classes.
1. Download and print each of these forms.
2. Complete your portion of the Annual Health Form (pages 1-3).
3. Please have a medical provider (MD, DO, NP, or PA who is not a family member) complete and sign both forms.
4. Upload a copy of both forms to the Patient Portal. Not needed if completed at the UGA University Health Center.
5. Upload a copy of the Healthcare Provider Attestation Form ONLY to the College of Pharmacy's CORE ELMS database using the directions provided by the College.
6. Retain a copy of submitted form(s).
Patient Agreement Form
If you are a student and will be under age 18 on the first day of classes: Please download and print the Patient Agreement Form and have your parents sign to give permission for the University Health Center to provide treatment. You must upload the printed and signed form to the Patient Portal (select “Immunization Upload”) before you can be seen for an appointment.
If you are a student and will be under age 18 on the first day of classes: Please download and print the Patient Agreement Form and have your parents sign to give permission for the University Health Center to provide treatment. You must upload the printed and signed form to the Patient Portal (select “Immunization Upload”) before you can be seen for an appointment.
Out Of State Student?
Use this form to access your state's immunization records.
Use this form to access your state's immunization records.
WHERE DO I SEND THESE FORMS?
Upload to UHC Patient Portal. Log in Select “Immunization Upload” from the left column. Upload Immunizations and TB Screening Form.
Email to uhcrhism@uga.edu
Fax to 888-218-9658