Student Health Services at Moffitt Health Center
Patient Forms
Page Content
Please pardon our progress as we make some updates to our website.
If you need any of the forms listed below, please call us at 601.266.5390 or send us an email%20with your request.
- Certificate of Immunization Compliance - 121 Form
- Consent to Release ADHD Medical Records to Moffitt Health Center
- Consent to Release Medical Records from Moffitt Health Center
- Consent to Release Medical Records to Moffitt Health Center
- Controlled Substance Good Faith Agreement
- USM Pharmacy Delivery Consent Form
Contact Us
Phone Numbers
Clinic 601.266.5390
Pharmacy 601.266.4075
Patient Hours
Clinic:
Fall and Spring Semesters
Monday-Wednesday:
8 a.m. - 5 p.m.
Thursday: 9 a.m. - 5 p.m.
Friday: 8 a.m. - 4:30 p.m.
Thursday: 9 a.m. - 5 p.m.
Friday: 8 a.m. - 4:30 p.m.
Pharmacy:
Fall and Spring Semesters
Monday - Friday:
9 a.m. - 5 p.m.
Clinic & Pharmacy:
Semester Breaks & Summer
Monday - Wednesday and Friday:
8:00 a.m. - Noon,
8:00 a.m. - Noon,
1 p.m - 4:30 p.m
Thursday:
9:00 a.m. - Noon,
1 p.m. - 4:30 p.m.
