Please use this form when requesting records to be sent to University of Delaware Student Health Services from another facility where you received treatment.  Please print, complete and sign the form and send it to Student Health.   You can fax the form to 302-831-6407, send it as an email attachment to or mail it to:

Student Health Services

Laurel Hall

282 The Green

University of Delaware

Newark, DE  19716-8101



Release Form