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Forms & Policies

MSU SHW Policies & Procedures

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General Forms

  • ADD/ADHD Patient Authorization for Disclosure of Health Information Form
  • Financial Responsibility Form
  • Minor Consent Form for Parents/Guardians of Patients under age 18
  • MSU HealthTeam (and Olin) Notice of Privacy Practices
  • Patient Authorization for Disclosure of Health Information
  • Telehealth Consent Form

Alcohol, Tobacco, and Other Drugs Education

  • E-Chug Survey

Allergy & Immunization

  • Allergy History Information Sheet
  • Injectable Medications Questionnaire Form
  • MSU Immunization Policy for students (includes a link to the mandatory Immunization Self-Report Form for the office of the University Physician.)

HIV Testing and Counseling

  • HIV Knowledge Assessment Quiz [Pre-test Form]
  • HIV Testing Brochure (for more information)

Psychiatry

  • PHQ-9 (Chinese)
  • Self-Care Plan (Chinese)
  • Lucas Functional Assessment (Chinese)

MSU Employees

  • Labor and Student Payroll Form
  • Labor and Student Payroll Form plus Time Conversion Chart
  • Overtime/Comp Time Approval Form (for Supervisor)
  • Overtime/Comp Time Payroll Form
  • Overtime/Comp Time Payroll Form plus Time Conversion Chart
  • Payroll Record CTs 2017

Workers Comp

  • Authorization to Invoice MSU
  • Authorization to Invoice MSU - Employees not in the Lansing Area
  • Report of Claimed Occupational Injury or Illness

 

 

Policies and Procedures

  • Policies (requires login)

Student Health & Wellness

  • Go to SH&W

Counseling & Psychiatric Services

  • Go to CAPS

Health Promotion Department

  • Go to Health Promotion
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