All SHAC Forms

Below is a list of links to all SHAC online and/or printed (pdf) forms:

• • Accident & Sickness Claim Form State of NM - Chubb
  • Advance Health Directive
  • Allergy & Immunization Mailing Label (.pdf)
  • Allergy & Immunization Mailing Label (.png)
  • Ask a Question - Counseling
  • Medical Records Request
  • No-Show / Late Cancellation Petition
  • Outreach Request Form
  • Parental Consent Form (for Students Under Age 18)
  • Patient Rights & Responsibilities
  • Pharmacy Registration/Transfer Form
  • Stimulant Prescription Patient Treatment Contract
  • Tell Us How We Are Doing
  • Timely Care Parental Consent Form
  • Travel: Pre-Travel Questionnaire for Non-UNM Students, Faculty & Staff
  • Tuberculosis Screening Questionnaire
  • Respirator Medical Evaluation Questionnaire