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Health Services Forms
These forms are available in our office, but have been put online for your convenience. To use these forms, you will need to have Adobe Acrobat installed. Please fill out these forms, print them and turn them in to our office in Curry Hall.
For your first appointment, please have these forms filled out and with you:
If you need to request records from our facility or another facility, please complete the following form:
Notice of Privacy Practices — Please read our privacy practices to answer any questions or concerns you may have. Once you have read the information, please complete the Acknowledgement Form above. Please contact us at 575.562.2321 for more information.
Eastern New Mexico University
1500 S Ave K
Portales, NM 88130