University of Houston-Clear Lake
Health Services
Please click or tap the appropriate menu item below to indicate the forms you wish to complete.
Notice of Privacy Practices
Demographic Information
Report of Medical History
Women's Health History
General Consent for Care and Treatment
Telemedicine Consent Form
COVID-19 Informed Consent
Cancellation/No-Show Policy Acknowledgement
Influenza (Flu) Vaccine Questionnaire/Consent Form
Patient Satisfaction Survey
Meningitis Vaccine Consent
Authorization for Release of Medical Records