Forms
Continue to main contentPolicies, Procedures, and Guidelines
- Responding to an Order of Subpoena Requesting Student Records – Civil Action
- Request for Confidential Communications
- Request for Restriction of Use and Disclosure or Revocation of Authorization
- Summary Notice of Privacy Practices: Southeast Missouri State University Autism Center for Diagnosis
Health Related Policies and Requests
- Campus Health Clinic Notice of Privacy Practice Information
- Authorization for the Use and/or Disclosure of Protected Health Information
- Health Information Privacy Complaint Form
- Request for Access to Protected Health Information or Request for Review of Denial of Request for Protected Health Information
- Request for an Accounting of Disclosures of Protected health Information
- Request to Amend Protected Health Information
- Southeast Missouri State University HIPAA Notice of Privacy Practices
Contact Us
Phone
Email
Location
Office
Academic Hall 139
Mailing Address
One University Plaza, MS 3000
Cape Girardeau, MO 63701
Cape Girardeau, MO 63701