Health Services
Forms
- Under the Age of 18 Consent to Treat Form (DocuSign)
- Privacy Notice
- Student Health Form (PDF)
- Allergy Injections Form (PDF)
- Disclosing Health Information (PDF)
- Receiving Health Information (PDF)
- Special Parking Permit (PDF)
- Student Shipment Form (PDF)
- Therapeutic Injection Order Form (PDF)
The following form is required for enrollment and course registration at Tennessee Tech:
- Certificate of Immunization (PDF), or you may submit a copy of your Immunization Record from a Health Care Provider to healthservices@tntech.edu or by faxing them to 931-372-3848.
The following forms should be completed by the student or their parent/legal guardian (if under the age of 18 as of the date of submission of this form) using DocuSign:
Make an Appointment
Phone: (931) 372-3320
Fax: (931) 372-3848
Email: healthservices@tntech.edu
Campus Box 5096
Cookeville, TN 38505
8am to 4:30pm CST
Office Information:
Location: Bell Hall 105Phone: (931) 372-3320
Fax: (931) 372-3848
Email: healthservices@tntech.edu
Mailing Address:
Health ServicesCampus Box 5096
Cookeville, TN 38505
Office Hours:
Monday - Friday8am to 4:30pm CST