University Health Clinic
New Patient Forms
Welcome to the UT Tyler Student Health Clinic. In order to serve you better we would like for you to complete the forms below and bring them with you on your first visit or email them to our office. We would like your address at school on the Patient Information form. The second part of this form can have your parents name and your permanent home address. Put "None" or "N/A" if you have never had any of the illnesses or procedures asked. If you do not know the dates of your vaccines, put either "Current" or "Unknown". Always bring your student ID with you when you come to the clinic. Your first visit will last about 1 to 1 1/2 hours, so you may bring something to study if you like. We look forward to helping you stay healthy during your years here at The University Of Texas at Tyler.
•New Patient Forms (.pdf)
•Health Survey (.pdf)
University Health Clinic 3310 Patriot Drive Tyler, Tx 75701