KSU Health Clinic: Patient Information

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Immunization Form (PDF)
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Patient Information

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Confidentiality

Medical information is confidential and will not be released with out the patient's written consent except as required by law.


Records Requests

CLICK HERE FOR THE MEDICAL RELEASE FORM (PDF)

Patients may request a copy of their records several ways:

  • Download the above form, fill it out and fax it to us at 770-499-3655. If you are only requesting immunization documentation, please fax to 678-797-2224. Incomplete forms will not be processed.
  • Faxing to us a letter that includes your name, KSU id#, approximate date of last visit to the clinic, what records you are requesting, a mailing address and fax # of where the records are being sent to. We also need a copy of your driver's license to process the request.
  • KSU will povide/send 1 copy of a student's entire file at no charge. Any additional requests are subject to a $20 search and retrieval fee and a $.65 per page charge to copy the records.

By law (O.C.G.A. 50-18-70 through 50-18-72), KSU has 3 days to respond to any records request. Usually, we turn them around in 24 hours.

Fax # 770-499-3655


Appointments

Appointments are scheduled:

Monday, Tuesday and Thursday - 8:15 a.m. - 3:30 p.m.

Wednesday - 9:15 - 3:30pm

Fridays are generally reserved for walk in visits only. A provider may schedule you an appointment for a follow-up visit.

Appointments are required for the following services:

  • Blood/Lab tests - Including Cholesterol, HIV, STD, Blood Sugar, Thyroid etc.
  • Travel Immunizations
  • Any type of physical exam (Women's, Nursing, Pre-participation Sport, Scuba, ROTC, Travel etc)
  • Initial psychiatric consult
  • Follow up psychiatric care

If you are more than 15 minutes late to an appointment and you have not notified us, your appointment will be cancelled and you will have to reschedule your appointment for a different day/time.

If you miss a scheduled appointment with our psychiatrist or nurse clinical specialist, you will be charged a $25 "no show" fee.

For any visit to the Health Clinic, please have your KSU id with you. Your student status will be verified at check in.

Walk-in Visits

We accept walk in patients from 8-3 M, T &Th, W 9-3 and 9-2 on Fridays. A walk in visit is defined as a sick visit or an emergency. Please call us at 770-423-6644 to see if your issue is a walk in visit or if you need an appointment.

ATTENTION NURSING STUDENTS!

 

Your physicals are due April 17, 2008 for the Summer 2008 semester.

Do not wait until the last minute. Call today to book your appointment. Please bring to your appointment:

Your Nursing Physical form - COMPLETELY filled out. If it is not filled out, you will not be called to the back until it is done. We will not sign a form unless it is filled out.

Your immunization records. You can also fill out the immunization records portion of the form, we will verify the records and add your PPD if you need one.

 


Patient Fees

There is no charge for a patient visit. That is covered by your student health fee which is currently $47 per semester (starting Fall semester 2008), $23.50 for summer( summer 09). Charges for laboratory tests and prescription drugs may apply.

As of July 1, 2006 all charges incurred at the Health Clinic will be charged to the student's Banner account. The student can pay their balance either online using Owl Express or in person at the Bursar's Office. Any balance over 30 days will result in a hold being placed on your account. Any balance over 60 days will incur a late fee.

Students not taking classes for one semester can pay the health fee and continue to use the services at the Health Clinic. This is good for one semester only.

CLICK HERE FOR A LIST OF AVAILABLE SERVICES AND CHARGES:

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Insurance

Click here for student health insurance information.

 

 


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