Patient Forms
All forms are in a digital and secure format. Simply locate the form required, fill it out on your device and click the submit button!
New CHC/SEK Patients
(for CHC/SEK to receive your Bryant Student Health Center Records for visits prior to August 7th, 2023)
Current CHC/SEK Patients
- Demographic/Consent to Treat – English
- Demographic/Consent to Treat – Español
- Release of Information - English
- Release of Information – Español
- Permission to Verbally Share Health Information – English
- Permission to Verbally Share Health Information – Español
- Financial Assistance – English
- Financial Assistance – Español
- EDW ENrollment Form - English
Behavioral Health Patients
School-based Health Patients
Questions?
You can call us at 620-231-9873 seven days a week and speak to one of our experienced, friendly staff who will be able to help you.
Our communication center is open:
7:00 am – 7:00 pm
Seven days a week