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Forms & Documents

21st Century CURES Act

NEW! In accordance with the 21st Century CURES Act, medical health records are now viewable via the Patient Portal in the "Medical Records" tab. 

Absence Note Guidelines

The CSUSB Student Health Center provides two types of notes for class and both require a visit:

  • Verification of visit for any scheduled appointment. This note verifies you were seen on a particular time and date, and nothing else.  It does not include a diagnosis nor recommendations for missed activities. 
  • Medical documentation during visits for significant medical illness or injury requiring substantial time off from school. 

We do not routinely provide medical excuse notes.

The majority of legitimate medical issues that cause students to miss class are due to conditions that get better on their own, such as colds, headaches, stomach flu, etc. These illnesses tend to be difficult to confirm objectively, especially after the fact.

In most cases these conditions improve with self-care (fluids, resting in bed) and do not require a medical visit.  

The Documents section on this page contains links that will allow students to print an Absence Self-Verification Form, and a Letter to Faculty from the CSUSB Student Health Center, and articles explaining current best-practices set forth by the American College Health Association.


All medical records are strictly confidential. Information from records will not be released to any one without the written authorization of the patient, except as required by law. The staff at the Student Health Center can assist you with the following services:

Health information is confidential, information in the health record will not be released to parents (except in the case of minors), professors or anyone else without written consent or when required by law, court order or when subpoenaed.

  • Advance Directive (PDF) An Advance Directive is a written document in the form of a living will or Durable Power of Attorney prepared by a competent individual that specifies what, if any, extraordinary procedures, surgeries, medication or treatments the patient desires in the future, when he or she can no longer make such decisions about medical treatment. Please see the attached form and instructions for more detailed information.
  • Release or Request of Medical Records form (PDF) Consent is required to release medical records to another facility or provider. Consent is also needed to release any medical records from an outside physician or health care facility that is mailed directly or faxed to the CSUSB Student Health Center. Proof of identity is required to pick up records in person. Records cannot be mailed or faxed directly to students. Please indicate specific dates needed and allow 7-10 working days to process.
  • Consent for Medical Treatment of a Minor (PDF) Parental consent is required to provide health care to minors. 
    *(Exceptions- California Law: Request for contraception services, or an Emancipated Minor)