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:

Enter your net ID and password
Enter your date of birth
Click on Forms (at left)


*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:


If you are a UTHSC student or employee, you may now schedule appointments, exchange messages with UHS staff, complete forms or surveys, check your financial account summary, or review/print immunizations through a secure online web-based portal using your NetID and password! You can also call (901) 448-5630 to schedule an appointment. An after hours on call providers are available to you by calling (901) 541-5654.


Monday to Friday 8:00 a.m. - 5:00 p.m. (close daily between 1:00 p.m. to 2:00 p.m.)


910 Madison, 9th floor

Contact Us

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

Contact Us