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York College Student Health Services Center

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How to submit — by Rafael Nunez — last modified Feb 09, 2021
FREE Immunization — by Rafael Nunez — last modified Feb 09, 2021

Medical Record/Physical

ONLY the student fills the Medical Record page. ONLY the healthcare provider fills the Physical page.

Download Medical Record and Physical Forms Revised 2015.pdf — 982 KB

Email StudHealthSvcCtr@york.cuny.edu if you need assistance. Follow us on twitter @york_health for updated information.