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Forms

This section provides quick access to all the forms you will find on our website.

Insurance

  • Health Insurance Domestic Waiver Form  (open only during waiver period)
  • Health Insurance International Waiver Form  (open only during waiver period)
  • Health Insurance Voluntary Enrollment Form (open only during enrollment period)
  • Health Insurance Waiver Reversal Form

Immunization

  • Med+Proctor Immunization Form for Domestic Undergraduate Students
  • Med+Proctor Immunization Form for Domestic Graduate Students (living in USF-housing)
  • Med+Proctor Immunization Form for International Students
  • Immunization Appeal Form

Other Forms

  • DHMG New Patient Form
  • Health Promotion Workshop Form

Health Promotion Services

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Quick Links

  • Schedule a Primary Care Appointment at Dignity Health
  • Learn more about your Urgent Care options
  • Submit Immunization Requirements
  • Text Crisis Text Line
  • Office of the Dean of Students

Health Promotion Services

2130 Fulton St.
University Center 5th Floor
San Francisco, CA 94117

Hours: 8:30 a.m. – 5 p.m.

(415) 422-5797

(888) 471-2290

hps@usfca.edu

Schedule Appointment

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