Southeast Missouri Hospital

For Students

• Please bring to your first appointment:
  • completed demographic form; one will have to be completed before the first visit
  • health history form (including medication list and past medical/surgical history); one will have to be completed before the first visit
  • health insurance card (with the cardholder’s name, date of birth and social security number) student ID and driver’s license
• Leave a number where we can contact you on the demographic form
• Please check your voice mails and e-mails; this is how we will communicate with you—it’s important to check your messages!
• The Campus Health Clinic will not release the reason for your visit unless you specifically let the office know, in writing, that it’s permitted.