UHS

New Patient Forms

New patient forms are now accessible through a secure web-portal called OpenCommunicator where patients can submit their information. Just go to the following link:

http://pnc-portal.uthsc.edu

Enter your net ID and password

Enter your date of birth

Click on Forms (at left)

 

FORMS AVAILABLE:

*Consent for Treatment

*Health History Form

* Insurance Information Page

*Notice of Privacy Practices

*UTHSC Required Immunizations for Students

High Risk Tuberculosis Screening Questionnaire

University Health Services Downloadable Forms

 

Printable forms, complete them and bring with you on your first visit.

Advance Directives Form

Medical Records Release Forms

 

For more information about Advance Directives: click on this link.

http://health.state.tn.us/AdvanceDirectives/index.htm

 

Crisis Information

Information about what to do in case of various emergencies.


Contact UHS

910 Madison Ave. Suite 922
Memphis, Tennessee 38163
Phone: 901-448-5630
Fax: 901-448-7255