Long Beach, CA 90802


Mon - Sun 8 am - 8pm
Open on all Holidays

Uga Patient Agreement Form

Office visitation fees will be charged to travel patients, plus vaccination fees for vaccines received. We submit insurance and charge the patient for any costs not covered. We recommend that patients check with their insurance companies about the details of their insurance coverage. More information about patients eligible for UHC insurance and clients who have scheduled appointments is billed at $20 for late arrivals or missed appointments. This includes same-day appointments. Look at the university health center`s privacy practices. (Adobe pdf) Please fill out the worksheet for the clinic before you call to book an appointment. Bring the three forms below and the requested information (vaccination file, medication list, etc.) to your appointment. The following vaccination certificate and TB screening forms must be printed and completed before you can register for education.

Please send all forms before you arrive at your orientation session. Your doctor must sign your vaccination certificate. Please keep a copy of your vaccines for your registrations. More information on vaccinations needed If a student wants to change a UHC medical clinic team or PCP team for any reason, this is a simple process. Tell your clinic nurse or provider to initiate the change. Warning Students from the age of 17: please download the patient agreement form and print it out and have your parents sign to give the treatment authorization to the University Health Centre. You must send the form to the address above to the right of the form, download the printed and signed form through the UHC Patient Portal (select “Immunization Send”), fax the number below or bring the signed form before being accessed for an appointment. Parental signature on the form is required so that students under the age of 18 can be processed at the UHC. More information about your medical records The patient and the patient`s family are responsible: If traveling abroad is in your future plans, your best local medical resource is the Travel Clinic at the University of Georgia Health Center. Our comprehensive clinic offers travel health advice based on epidemiological information, vaccinations and prescriptions (z.B prevention of malaria). The travel clinic is available to students, teachers, staff and the general public (from 2 years old). It is a violation of the University of Georgia`s anti-discrimination policy to conduct any form of sexual activity or behavior involving another person without the consent of the other person.

Consent is defined as: clear words or acts that are knowingly, freely and actively given, indicating permission to participate in agreed sexual activities. The absence of a “no” vote is not a “yes.” Consent cannot be granted if physical violence, threats or intimidation1 or sexual assault are used to obtain consent. Consent consists of three important elements: click here to download and print the patient agreement form. Read it, sign it and send it with your vaccination form. UGA students can make appointments online and any authorized patient can call the clinic directly to agree on a favourable deadline. WARNING: The yellow fever vaccine (YF-VAX) is not currently available in the United States. The offer is expected to return in 2020. There are 5 sites in Georgia where Stamaril (a yellow fever vaccine made available by the FDA on an Investigational New Drug program) is available. For more information: wwwnc.cdc.gov/travel/yellow-fever-vaccination-clinics/search. The Travel Clinic continues to offer all other services, including travel and routine vaccines, antimalarial prescriptions and travel health guidelines.

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