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Forms and Links

Medical Records Release Documents

  • This packet includes the forms you will need to complete and bring with you to your first visit along with your insurance card, KSU Student ID, and driver’s license.
    FORM DOWNLOAD
  • Use this form for Student Health Services visits that occurred prior to April 1, 2014.
    The form can be hand delivered to Auxiliary Services and Programs at 3213 Campus Loop Road or faxed to 470-578-9332.
    FORM DOWNLOAD
  • Use this  form request that your primary care or other physician provides your records to WellStar Student Health Services.
    FORM DOWNLOAD
  • Psychiatry is part of KSU’s Counseling and Psychological Services (CPS).
    Use this form to request psychiatric and counseling records.
    FORM DOWNLOAD
  • Use this form to request a copy of immunization records submitted to KSU as part of the enrollment process. For additional information on KSU’s immunization requirements.
    FORM DOWNLOAD

Student Health Insurance Plan (SHIP) Forms

  • The University System of Georgia offers an affordable health insurance option for students enrolled at KSU. For a summary of the SHIP plan and eligibility requirements.
    READ MORE
  • Use this form to enroll in the SHIP program in conjunction with a Qualifying Life Event (QLE). This form is required when enrolling in current coverage period and open enrollment is closed. This form also has dates of coverage and the corresponding plan rates.
    FORM DOWNLOAD
  • Use this form if you have experienced a Qualifying Life Event (QLE) and wish to enroll in the SHIP plan for the remainder of the current coverage period. Examples of QLEs are a change in marital status, birth of a child, job loss or loss of coverage due to age.
    FORM DOWNLOAD

Medical Resources: CDC, Cobb Health

  • Refer to the CDC (Centers for Disease Control and Prevention) travel website link to determine immunizations needed for travel out of the country.
    READ MORE
  • The KSU Health Advisory website provides public health related advisories and information for students, to help advise and mitigate any incidence of preventable and infectious diseases within the campus community.
    READ MORE
  • Cobb & Douglas Public Health is your resource for better health and wellness. Whatever your needs, we can assist you in finding the right care or connect you to a program that can help.
    READ MORE
  • As a unit of the University System of Georgia, Kennesaw State University is required to adhere to the Board of Regents Guidelines regarding immunizations for school entrance. For additional information on KSU’s immunization requirements.
    READ MORE

  • Our Hours

    Monday – Friday
    8:30 AM – 5:00 PM


    Schedule an Appointment
    Call: 470.578.6644
    Login to MyChart

  • Our Services

    Student Health Services provides comprehensive primary care on both the Kennesaw and Marietta campuses. Our clinical team is comprised of board certified physicians and advanced practice providers.
    Learn More>
  • Our Locations

    Student Health Services provides comprehensive primary care on both the Kennesaw and Marietta campuses. Our clinical team is comprised of board certified physicians and advanced practice providers.
    Learn More>
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