Medical Forms

Medical Forms

Medical Information

Doane University Student Health Services is committed to providing the best possible health services for our students. In an effort to do just that, each new student to Doane is required to complete health related information and immunization history via Doane's student health portal: doane.studenthealthportal.com

Students will need to use their Doane email and password to complete the student health portal. Immunization records and/or other health documentation must be uploaded to the student health portal, do not send hard copies unless requested to do so.

Student Health Information


Permission to Release Records

If you need your medical records released to another institution or facility, please fill out and return the Authorization for Release of Medical Information form. 


Questions or Contacts

If you have additional questions or concerns about the Medical History Report form or the Student Health packet, please contact our Director of Health and Wellness,
Kelly Jirovec:

work: 402.826.8265
e-mail: kelly.jirovec@doane.edu