For information regarding notice of an absence from class related to illness or injury, please click here.

Notice: All of the forms listed on this page are PDF (Portable Document Format) files. The Adobe Acrobat Reader is required in order to view and print these files. If you already have the Adobe Acrobat Reader, just click on the form and it will open the Acrobat Reader and allow you to print the document. If you do not have the Adobe Acrobat Reader, simply download and install it. You can download the reader free of charge at:
http://www.adobe.com/prodindex/acrobat/readstep.html

Once installed, the reader will allow you to view and print these forms. You must complete the form, sign it, and return it to us.  

Prescription Allergy Injection Form (PDF Reader)
Allergy Injections must be ordered from a physician. Students can streamline the process of verification if the will have their physician fill this form out and bring it with them when they come.

Tuberculosis Screening Form (PDF Reader)
This is a one-page form used to document tuberculosis screening. The second page is used to obtain consent for medical treatment of a minor and should be completed and returned to SHS if the student will be under the age of 18 on the day that classes begin.

Medical Records Release Form (PDF Reader)
This is a two-page form used to request a copy of your health records. Again, we are required to receive your permission before releasing these records. This form must be completed, signed, and returned to us before the release of records can occur. You may mail in your form and payment, fax in your form and be contacted by SHS staff for payment, or complete the form and pay in person.

Consent for Medical Treatment of a Minor (PDF Reader)
If a new/transfer student will be under the age of 18 on the first day of university classes, the following form is required in order to provide legal consent for any possible medical care should it be necessary.

Explanatory Statement for Absence from Class (PDF Reader)
For an injury or illness less than three days, a student may be asked to complete the Explanatory Statement for Absence from Class form. A faculty member and/or academic department can request confirmation of the injury or illness by having students complete the Explanatory Statement for Absence from Class. 

Explanatory Statement for Absence from Class for Influenza-like Illness (PDF Reader)
This form is accepted as documentation for class absences related to influenza-like illness. This form is NOT accepted for injury or illness related to class absences for reasons other than influenza. A faculty member and/or academic department can request confirmation of the influenza-like illness by having students complete the Explanatory Statement for Absence from Class for Influenza-like Illness form.

The student will initiate this process by completing the form either online or manually. The form must be printed and signed. It is our understanding that emailed or other electronic copies will not be accepted. Submission of the form does not guarantee an excused absence. The choice to excuse or not excuse the absence is left to the discretion of the faculty member or academic department. The TAMU student rule can be found at http://student-rules.tamu.edu/rule07.

Prescription Transfer Form (PDF Reader)
Please call the pharmacy at (979) 458-8292 to verify that we stock your medication. Once you have confirmed that it is available, please complete the form to the best of your ability. You may then either fax the form in or bring the form to the pharmacy located on the first floor of the Student Health Center. Please allow 48 hours for the processing of transfers.

Emergency Refill Form (PDF Reader)
Please complete this form if you are a TAMU Galveston Student in need of a prescription refill. You can call the pharmacy at (979) 458-8292 to verify that we stock your medication. Once you have confirmed that it is available, please complete the form to the best of your ability. You may then either fax the form in or bring the form to the pharmacy located on the first floor of the Student Health Center.