Santa Rosa Junior College

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SHS HOME CURRENT EVENTS PUBLIC HEALTH NOTICES STUDENT HEALTH 101 ONLINE MAGAZINE SERVICES Healthcare Services Student Psychological Services Prospective Interns Health Promotion & Wellness REFERRALS & RESOURCES Community Resources Online Resources Health Insurance RESEARCH & REPORTS RESOURCES FOR FACULTY/STAFF SEXUAL ASSAULT PREVENTION ABOUT US Scope/Board Plan Health Fee Confidentiality Patient Rights & Responsibilities Student Health Services StaffDOWNLOAD FORMS

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Student Health Services Forms

Medical Consent for Treatment of a Minor (PDF: 20k)
Provider Notice of Privacy Practices (PDF: 24k)
Authorization to Release Medical Information (PDF: 28k)
Patient Rights & Responsibilities (PDF: 12k)
Athletic Health Screening Form (PDF: 206k)
Athletic Emergency Information Card & Consent to Treat (PDF: 252k)
Athletic Authorization to Release Medical Information (PDF: 76k)

Incident Report (PDF: 152k)

SHS Classroom Presentation Request (PDF: 73k)
SPS Intake Packet (PDF: 462k)
SPS Yellow Card Guidelines (PDF: 231k)
SPS Yellow Card Referrals (PDF: 189k)
First Aid Kit Supply Reorder Form (PDF: 63k)

Santa Rosa Junior College is officially accredited by the Western Association of Schools and Colleges