Health Forms
1 required form must be completed before your April 15 appointment.
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Required
Annual Health History Update
Required
Due Apr 14, 2025
Update your medical history, medications, and allergies for the upcoming year.
Pre-Visit Form — Primary Care (Apr 15)
Due Soon
Due Apr 14, 2025
Brief questionnaire about the reason for your upcoming visit with Dr. Sarah Kim.
Optional Forms
Consent to Release Records
Authorize UCSC to share your records with a third party.
HIPAA Authorization Form
Grant specific individuals access to your health information.
Mental Health Intake (New Patients)
Required for first-time CAPS appointments.
Completed Forms
Need Help?
For assistance with forms, contact the Student Health Center at (831) 459-2121 or visit the front desk during office hours.