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Procedures and Forms - Area-Specific

Purdue University Student Health Center (PUSH)

CAPS (Counseling and Psychological Services)

Authorization to Use or Disclose (pdf)     (doc)

Family Health Clinic of Carroll County

Authorization to Use or Disclose (pdf)    (doc)


Record of Disclosure, Chlamydia Report (pdf)    (doc)
Record of Disclosure, TB Report (pdf)     (doc)

Urgent Care

Record of Disclosure, Animal Bite Report (pdf)     (doc)


Authorization to release ED Team (pdf)     (doc)

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