Back to Top
Skip to Site Search Skip to Utility Nav Skip to Top Nav Skip to Left Nav Skip to Content
Close Main Menu


Medical History Form
Release of Health Information

In order to send your medical records to a third party health service or educational institution, please fill out the Medical Release Form and return to:


(706) 864-1448

Student Health Services
110 S. Chestatee St, Suite 100
Dahlonega, GA 30597

You may download the form from the link provided below:

**Please allow 48-hour notice for processing of immunization records.

Women's/Men's Medical History Form

UNG follows Section 508 Standards and WCAG 2.0 for web accessibility. If you require the content on this web page in another format, please contact the ADA Coordinator.

Back to Top