• Forms - Hendrix

Hendrix Clinic & Counseling Center

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  • Forms

    Attention newly admitted students: The following immunizations form and health history must be printed, completed, and returned to the health center before you can register for classes. You may submit the immunization information online or print out a copy to be sent to Hendrix Clinic and Counseling Center. Please keep a copy for your records.

    Required Prior To Registering For Classes:


    Other Forms:

     

    Requesting Health Information?
    If you request a copy of your health information to be given directly to you, there may be a charge based on the number of pages copied. There may also be a charge for records sent to insurance companies or legal offices.

    Fax Number
    218.477.5867

    Mailing Address
    Hendrix Clinic and Counseling Center
    1104 7th Ave South
    Moorhead, MN 56563

  • IMPORTANT:  All international students using United Healthcare Insurance:

    United Healthcare no longer sends out health insurance cards to members.

    Go to www.uhcsr.com, under Find My School's Plan, create a My Account and from there you can print out a card.

    You can access your benefit plan information 24 hours a day, 7 days a week from this same website from which you created your account; which will give you access to view coverage information and claim status, submit accident details, update other insurance information, or assign a personal representative.  Other features available, depending on your plan, include locating a provider or a pharmacy.  A number of these features can also be accessed during a smartphone through our mobile site at https://my.uhcsr.com or with our new mobile app, available on the Apple App Store and on Google Play.  If you need assistance, please call our Customer Service Representative at the toll-free number (1-800-767-0700) also listed on the back of your student health insurance ID card.

    Staff Only