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You are here: Home → Student Life → Student Affairs → Health Center → Registration Forms → Patient Registration Forms

Contact Information

Location:
Health Center, Tomichi Hall 104

Counseling Center:
Phone: (970) 943-2484
Emergency: (970) 252-6220
(Please tell them you are a WSC student in Gunnison)
Fax: (970) 943-2318
Email: health@western.edu

Medical Clinic:
Phone: (970) 943-2707
Fax: (970) 943-2218
Email: mdhealth@western.edu

Patient Registration Forms

Please be sure to print and fill all pages of the packet out before you come in for your scheduled appointment.

Patient Information Sheet
Notice of Privacy Practices
Acknowledgement of Privacy Practices
Health Summary
Patient Preventative Health History
Family History
Financial Policy
Medical Billing Release To Parents
Health Insurance Information