Skip to main content Skip to main menu
Search myState
  • Home
  • Contact Us
  • Clinic Services
  • Insurance
  • Pharmacy
  • Forms (current)
  • FAQ
Logo for Longest Health Center
  • myState on Mississippi State University
  • Directory on Mississippi State University
  • Home
  • Contact Us
  • Clinic Services
  • Insurance
  • Pharmacy
  • Forms (current)
  • FAQ

Forms

General

Advanced Healthcare Directive
Consent to Treat Minor Patient
Demographics Form
General Travel Information - Travel Clinic
Travel Sheet - Travel Clinic
MSU Immunization Form

FERPA Consent Form

HIPAA Consent Form

Initial Nutrition Assessment Form

Allergy Clinic

Instructions for Allergy Patients
Consent Form for Allergy Injections

Insurance

Student Insurance Brochure
 

Patient Confidentiality

Authorization of Disclosure of Health Information
Student Patients' Privacy Information (FERPA)
Private Patients' Privacy Information (HIPAA)
 

Mississippi State University M mark
Longest Student Health Center
P.O. Box 6338
Mississippi State, 39762
Mississippi State, MS 39762
Email health@saffairs.msstate.edu
health@saffairs.msstate.edu
Call (662) 325-2431
(662) 325-2431
Fax (662) 325-8888
(662) 325-8888
Logo for Mississippi State University