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  • Allergy Information & Forms
  • Hendrix Clinic & Counseling Center

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  • Allergy Information & Forms

    Hendrix Clinic and Counseling Center (HCCC) will administer allergy shots as ordered by a patient's allergist, as a courtesy to enrolled MSUM students. Initially, a patient must have their allergist (allergy doctor) fill out a Physician Ordered Allergy Serum form to receive allergy shots at HCCC. The allergist must fill out a new form on an annual basis for the student to continue receiving allergy shots at HCCC. The patient is responsible for reading through the Allergy Information Sheet and filling out the Allergy Injection Patient Agreement form. The Physician Ordered Allergy Serum form and the Allergy Injection Patient Agreement must be returned to HCCC before an allergy shot appointment will be made for the patient. These forms are available below.

    Criteria For Receiving Allergy Shots at HCCC  

    • Patients must be on a maintenance level before shots will be administered at HCCC.  All patients who are just starting or are restarting allergy shots must have their initial doses administered by an allergist before they will be seen at HCCC.  When they have reached a maintenance dose, they may be seen at HCCC.
    • Patients with a history of severe local or systemic reactions will not be able to receive allergy shots at HCCC.
    • Patients are responsible for their allergy serum.  HCCC does not order serum for patients and does not accept allergy serum that is mailed to HCCC.  Patients are responsible for hand carrying their serum to the clinic.  HCCC will store student serum in the clinic refrigerator during the course of the semester.  The student is responsible to return to HCCC during business hours to pick up serum before a holiday break or at the end of a semester.
    • A physician must be in the clinic when patients receive allergy shots.  On occasion an appointment may have to be rescheduled if the physician is unable to be in the clinic the day a shot was scheduled.
    • Allergy shots are not administered during the summer or when school is not in session, such as holiday or semester breaks.
    • Patients must schedule an appointment at HCCC to receive an allergy shot, it is not provided on a walk-in basis.

    Forms