STUDENT HEALTH SERVICES
 
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RELEASE OF INFORMATION
seporator

Students requesting medical /immunization records will be required to complete a Release of Authorization Form. 

Please fax the completed form to (504)520-7962 or Mail to: Student Health Services, 1 Drexel Dr., Box 36, New Orleans, LA 70125

Upon receipt of the Release of Authorization Form and payment your request will be fulfilled
within 48 – 72hrs.

 

click here to download and print form

NOTICE: Request for records will not be fulfilled during Xavier University of Louisiana Fall and Spring Registration.

Thank You
The Office of Student Health Services Staff

 

 
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EST 1925