SHS Forms

Appointment Forms

To fill out forms for your appointments, click here.

Authorization Forms

Release of Information or Medical Records.
Authorization for Release or Request of Information - PDF

Medical Exemption Request Form

Medical Exemption Request Form - PDF

Form Submission

Submit forms to Student Health Services in person, via fax or mail.

Confidential Fax Line: (562) 985-1644

Mailing Address:
California State University, Long Beach
Student Health Services
1250 Bellflower Blvd., Long Beach, CA 90840-0201