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Student Health and Wellness Center Confidential Counseling Intake Form Potential billing costs: SHE Behavioral Health appointments are not billed to insurance and are of no cost to students, however,

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How to fill out student health and wellness

01

Obtain the student health and wellness form from the school or institution.

02

Fill out personal information such as name, date of birth, contact information, and student ID number.

03

Provide details about any pre-existing medical conditions or medications the student is currently taking.

04

Sign and date the form to certify that all information provided is accurate and true.

05

Return the completed form to the appropriate school or institution office for processing.

Who needs student health and wellness?

01

Students attending school or educational institutions that require proof of health and wellness for enrollment or participation in activities.

02

Parents or guardians of students who need to provide accurate and up-to-date health information for their child's safety and well-being.

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What is student health and wellness?

Student health and wellness refers to the overall physical, mental, and emotional well-being of a student.

Who is required to file student health and wellness?

Schools or educational institutions are typically required to file student health and wellness reports.

How to fill out student health and wellness?

To fill out student health and wellness, information regarding the student's medical history, current health status, and any wellness programs or services utilized can be included.

What is the purpose of student health and wellness?

The purpose of student health and wellness is to ensure that students are provided with necessary support and resources to maintain their health and well-being while attending school.

What information must be reported on student health and wellness?

Information such as medical conditions, medications, allergies, emergency contact information, and participation in wellness activities may need to be reported on student health and wellness forms.

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