Information

Billing Questions

BILLING AND CLAIMS QUESTIONS

Campus Health Services files claims with most insurance carriers.  After payments are posted, invoices are sent to students for payment of the remaining charges.

For billing and claims questions, contact the Campus Health Billing Clerk at 502-852-6519.

To speed up your service, please have your Invoice number ready to give to the Billing Clerk.

For additional assistance with insurance claims, send an e-mail to stuins@louisville.edu or. Include your name and a short description of the problem.  The Insurance Advocate will respond within 48 hours.

Forms

General Patient Forms

 

Foreign Travel Forms

Healthcare Readiness Checklist

HIPPA Communication Preferences Authorization

HIPPA Notice of Privacy Practices

Medical Records Request-- to request records from Campus Health Services

Medical Records Request -- to request records to be sent to Campus Health Services (HSC)

Medical Records Request -- to request records to be sent to Campus Health Services (Cardinal Station)

Minor Consent Form

New Patient Forms

Patient Rights and Responsibilities

Personal Health, Medication & Immunization Card

Release of Psychotherapy Records Form - to request records be sent from Campus Health Services

Telehealth Consent Form (Fillable/signable PDF) - for remote counseling services 

UofL Sports Medicine Physical Form


Academic Health Plan / Insurance Forms

 

How to File Claims

United Healthcare Claim Form


International Students

 

International Student Health Insurance Waiver Categories


Health Sciences Center Immunization Forms

 

HSC Student Immunization Tracking Form - to submit with your immunization records

HSC Housestaff Immunization Tracking Form - to submit with your immunization records

HSC Housestaff Immunization Tracking Form - to submit with your immunization records (PDF format)

Instructions to Upload Out of State COVID Immunization Forms

 

Clinical Trainees Respiratory Fit Testing 

Respirator Medical Questionnaire for Clinical Trainees

 

Employee Health-Related Forms 

N95 Decon Respirator Medical Questionnaire (use only for N95 Decon program)

IACUC Medical Surveillance Questionnaire 

Respirator Medical Evaluation Questionnaire

BSL3-ABSL3 Medical Surveillance Forms

Workers Compensation Forms for Faculty and Staff of the university


Patient Drug Assistance

 

Patient Drug Assistance Information

Implanon Patient Assistance Form

Mirena Patient Assistance Form

Paragard Patient Assistance Form


Reporting Sexual Misconduct or Assault

 UofL Anonymous Reporting Form

Frequently Asked Questions

How do I make an appointment?

Can I just walk in or do I need an appointment?

What is the cost of an office visit?

How do I pay for my visit?

Will I have to pay anything at each appointment?

Do you accept insurance?

Do I need an insurance card?

Will you see me if I don’t have insurance?

Do you take Medicare, TRICARE, Medicaid, or Passport?

Can I get a PAP/women’s exam?

Do you do TB testing?

Is STI testing available and is it free?

Do I need to submit my immunizations to attend class?

Do I need the Meningitis vaccine?

Doctor's note: If I've been sick and unable to attend class can you provide a doctor's note?

What is Health Promotion and what services do they offer?

What is PEACC and what services do they offer?

 

How do I make an appointment?

To make an appointment, please call one of the numbers below:

Cardinal Station Office:(502)852-6479
HSC Office: (502) 852-6446

For more information on scheduling an appointment, visit: http://louisville.edu/campushealth/services/medical-care/schedule-an-appointment

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Can I just walk in or do I need an appointment?

It is always best to call and schedule an appointment for a set time to assure you can be seen.

However, in the event you come to Campus Health requesting to be seen as a walk in, you will be accommodated until 4 PM as long as we have the capacity. 

As a walk in patient, you may choose to wait to be seen until you can be worked in or choose to be scheduled for an appointment the following day.

Visits deemed urgent by our medical staff will be worked in as fast as possible..

For more information on scheduling an appointment, visit: http://louisville.edu/campushealth/services/medical-care/schedule-an-appointment

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What is the cost of an office visit?

New and established office visits are covered at the Campus Health Offices for students who paid the Primary Care Health Fee (PCHF) or the HSC Health Professional Fee. Office visits are also covered for students enrolled in the University sponsored Student Health Insurance Plan. Otherwise, office visits are billed according to your insurance plan. Campus Health files claims with most insurance companies, including Medicare and Tricare. Copays may be due at each appointment. Uninsured students who did not pay the PCHF, will be responsible for any charges.

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How do I pay for my visit?

Campus Health Services accepts checks, money orders, VISA, Mastercard, American Express, Discover, and Diners Club for payments. We DO NOT accept cash. You may make payments at either Campus Health Services location.

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Will I have to pay anything at each appointment?

Based on your insurance company, you may have to pay copays or deductibles. Students who purchased the Student Insurance plan or paid the PCHF may not owe anything at checkout but could have charges billed to their insurance carrier. Uninsured students will be charged for services performed at Campus Health that are not included in the PCHF.

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Do you accept insurance?

Campus Health accepts and files claims with most insurance companies including Medicare and Tricare. Based on your insurance plan, you may be responsible for copays or treatment charges at the time of service.

http://louisville.edu/campushealth/information/insurance

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Do I need an insurance card?

You will need your insurance card if you have coverage. Items you will need to bring include:

  • Insurance card or copy of front and back of the card
  • Student ID
  • Driver's license or passport
  • Your social security number
  • Military ID if you have TRICARE insurance

If you are covered on your parent's or spouse's plan, you will also need:

  • Subscriber's name (person who carries coverage on you)
  • Subscriber's employer
  • Subscriber’s social security number
  • Subscriber's address

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Will you see me if I don’t have insurance?

Campus Health welcomes all University of Louisville students. Claims are filed for most insurance companies including Medicare and Tricare. Uninsured students who pay the Primary Care Health Fee will have office visits and in-house labs paid but all other services will be billed to the student. The PCHF is not insurance and is only good at either of the Campus Health offices. Uninsured students, who were not charged the PCHF, may purchase it at any time by sending an e-mail to stuins@louisville.edu.

For more information on the Primary Care Health Fee visit http://louisville.edu/campushealth/information/fees

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Do you take Medicare, TRICARE, Medicaid or Passport?

Campus Health bills Medicare and TRICARE, but not Medicaid or Passport. If a student with Passport or Medicaid wants to use the services at CHS, you may pay for services based on our cash fee scale or you may purchase the Primary Care Health Fee (PCHF). All other charges are the student's responsibility. Students who wish to purchase the PCHF may purchase it at any time by sending an e-mail to stuins@louisville.edu or by speaking with a staff member at the time of your visit.

For more information on the Primary Care Health Fee, visit: http://louisville.edu/campushealth/information/fees.

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Can I get a PAP/women’s exam?

Yes, these services are offered at both Campus Health offices. For more information visit: http://louisville.edu/campushealth/services/medical-care

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Do you do TB testing?

Yes, Campus Health administers annual TB tests at both locations. For more information, visit: http://louisville.edu/campushealth/information/immunizations

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Is STI testing available and is it free?

STI testing is offered at both Campus Health Offices. Testing is either billed to your insurance or paid for at the time of service based on our discounted fee schedule. If your labs are charged to your insurance, you will be responsible for any copays or other lab charges. You may want to check with your insurance company to confirm coverage prior to receiving any services. For more information about STI's visit: http://louisville.edu/campushealth/services/medical-care/sexual-health-contraception

Free HIV and syphilis testing is offered at the Health Promotion Office located in the Student Services Annex, between the Houchens building and the Student Activities Center (SAC). Visit the Health Promotion web site for details: http://louisville.edu/healthpromotion

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Do I need to submit my immunizations to attend class?

Immunizations are required for

  • All first time freshmen students for the 2014-2015 Academic year.
  • All students enrolled in the MD, DMD, RN, ARNP, Dental Hygiene, Audiology and Speech Pathology programs

For more information visit: http://louisville.edu/campushealth/information/immunizations

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Do I need the Meningitis vaccine?

CHS recommends that all students living in housing facilities be vaccinated for Meningitis. Beginning Fall 2014 all first time freshmen students will be required to provide proof of the meningitis vaccination. Visit http://louisville.edu/campushealth/information/immunizations for more information.

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Doctor’s note: If I’ve been sick and unable to attend class can you provide a doctor’s note?

Campus Health can provide a basic sick note for a student if warranted. However, class attendance policies vary by academic unit and professor, therefore we recommend that you consult with your academic dean or your professor regarding their attendance policies. Campus Health strongly recommends that you communicate with your professor in advance of or at the time of an absence.

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What is Health Promotion and what services do they offer?

The mission of the Health Promotion Office is to promote the vitality, health, academic excellence, and resilience of the University of Louisville campus community through accurate and non-judgmental health programming, advocacy, and peer mentorship. We are working to build a campus community that values health by increasing access to healthy options and encouraging critical thinking about health decisions. Most programs are free or feature student-friendly prices.

Programs offered are U-Fit, Yoga, Chair Massages, Nutrition Counseling, Stress & Sleep, Alcohol and Substance Abuse, Sexual Health & Relationships, and information on how to stay healthy.

For additional information visit: http://louisville.edu/healthpromotion

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What is PEACC and what services do they offer?

PEACC works to end power-based personal violence by utilizing a prevention model that decreases victimization and builds capacity for positive relationships and social interactions. Contact PEACC at 502-852-2663 or Call or Text 24/7 at 502-714-8923. Visit the PEACC web site at: http://louisville.edu/peacc/

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Fit Testing

N95 training is provided through the University’s Bioraft education platform. Using your ULINK ID and password log into Bioraft using the following link: N95 Training for Students-Interns-Residents. Once you have completed the training and quiz log off and your status will be updated in Bioraft. Please call 852-2708 with any questions or problems.

To schedule your fit test, please call the HSC Campus Health Office located in the HCOC building suite 110 at 852-6446 to schedule your fit testing appointment. Please arrive with your N95 training, quiz and medical questionnaire completed.

Information for Students Who are Graduating or Have Graduated

graduate continuity of care continue not a student

In preparation for graduation, you should begin to make plans regarding where you will receive your healthcare once your are no longer a student.   

1.  Following graduation Campus Health Services will continue to see you for up to 3 months after graduation on either a cash basis or billing your insurance.  You are responsible for any copays or deductibles after payment is received from your insurance carrier.  

2. You should schedule an appointment with a community provider as soon as possible preferably before you even graduate.  The waiting time for many primary care providers is 3-6 months for a new appointment. 

3.  Request a copy of a your medical records to send to your new provider by filling out a medical records release with the practice information filled out.  

4.  If you are currently covered on the University sponsored student insurance account, please contact the Student Insurance Advocate for  insurance options after your current coverage expires.  The Student Insurance Advocate can be reached at 502-852-6519 or via email stuins@louisville.edu    

 

 

 

 

Self Isolation Guide

What Does it Mean to Self-Isolate?

Self-isolation is a voluntary agreement to remain at home and not to go to work or school, limit your movements outside and monitor your health for 14 days after returning from a high risk country or area. 

How Do I Self-Isolate? 

  1. Stay at home and do not go to class or participate in any campus activities. (The university will work with you to arrange for remote access to classes if appropriate.
  2. Do not go to work. Consider working remotely if that is an option until the monitoring period has ended.
  3. Avoid all non-essential travel around the community and campus.
  4. Avoid crowds, public events, meetings, social activities, or other group activities
  5. You may go shopping for food or take a walk outside but may wish to utilize home deliver services such as Amazon, Grub Hub. 
  6. Do not share utensils, toothbrushes, water bottles, pillows, and avoid shaking hands, kissing, hugging, or other intimate activities. Avoid close contact. (Close contact is defined as closer than a 6-foot distance between you and others.) If you have a roommate, keep the recommended distance apart.
  7. If you must go to a medical appointment, call ahead and make arrangements on how to enter to office in order to reduce your chances of exposing other patients or staff.

How Do You Monitor Your Health? 

You will be asked to monitor your temperature twice a day; ideally in the morning and again in the evening.

Please contact Campus Services if you develop a temperature greater than 100.4 (F), cough or sore throat while in self-isolation at 502-852-6446-or 502-852-6479.  A nurse or physician will be available to speak with you directly when you call.

What If I Become Sick?

If you become ill during self-isolation CALL UofL Campus Health Services at 502-852-6446 or your nearest emergency room before going to any healthcare facility.   This is to protect other patients and ensure that you are in insolation immediately upon arrival.   Remember CALL FIRST!  

If You Must Go Out for Essential Reasons 

  1. Cover your mouth and nose with a tissue when you cough or sneeze
  2. Wash your hands often with soap and water. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available
  3. Avoid shaking hands
  4. Do not travel 

When Can You Return to Work or School?

If you do not have any symptoms and feel healthy after self-isolating, you can return to your regular duties.   Campus Health Services can provide documentation that you have been cleared to returned to work or school if necessary.  

Please email us at hlthoff@louisville.edu if you have any questions.

Monkeypox FAQs

Monkeypox is a disease caused by a virus (Monkeypox virus) not commonly seen in the United States. Monkeypox can cause a rash which may look like pimples or blisters, sometimes with a flu-like illness.

You may experience all or only a few of the symptoms of Monkeypox.

  • Most people with Monkeypox will get a rash which can start before or after the viral syndrome (flu-like symptoms).
  • The flu-like symptoms may include fever, headache, muscle aches and backache, sore throat, cough, swollen lymph nodes, chills, or exhaustion.
  • The rash typically develops 3-4 days after the flu-like symptoms.

The lesions are slightly raised with a fluid filled dome or pustule. The lesions often had a central depression which is termed umbilicated. The lesions tend to form on the central part of the body and then appear later the extremities. Eventually the lesions scab over and remain infectious until the scab falls off.

Examples of Monkeypox Lesions

Examples of Monkeypox Rash

Please contact your healthcare provider or Campus Health Services at 852-6479 as soon as possible and ask to speak with a nurse or provider who can assist in getting you evaluated.

Monkeypox can be spread any time from the initial symptoms until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed underneath the skin. This can take from 2-4 weeks.


You only need to isolate if you have symptoms of Monkeypox such as fever, chills and muscle aches or you develop a rash. The illness can take 2-4 weeks to resolve.

Monkeypox symptoms usually start within 3 weeks of exposure to the virus.

Monkeypox can spread to anyone through close, personal, often skin-to-skin contact including:

  • Direct contact from a person with Monkeypox who has the rash, scabs, or body fluids.
  • Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with Monkeypox.
  • Contact with respiratory secretions while lying next to someone

YES. Monkeypox can be transmitted from the clothing and bedding of an infected individual. Appropriate use of personal protective equipment including gloves is recommended if you must handle potentially infected materials. Standard laundering with detergent inactivates the virus and no additional precautions need to be taken. Soft surfaces such as carpeting or furniture and hard surfaces that cannot be laundered should be sprayed with an EPA approved disinfectant and allowed to dry before using.

Yes. Any close bodily contact with someone who is infected with Monkeypox can cause the infection to spread. This contact can happen during intimate contact including:

  • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with Monkeypox.
  • Hugging, massage, and kissing.
  • Prolonged face-to-face contact.
  • Touching fabrics and objects during sex that were used by a person with Monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.

Festivals, events, and concerts where attendees are fully clothed and unlikely to share skin-to-skin contact are safer. However, attendees should be mindful of activities (like kissing) that might spread Monkeypox.

Any activity where there is there is minimal clothing and where there is direct, personal, often skin-to-skin contact has some risk. Avoid any rash you see on others and consider minimizing skin-to-skin contact.

Yes and No.

There is NOT a specific vaccine against Monkeypox but because it is in the same family as Smallpox; the Smallpox vaccine is effective against Monkeypox. There are currently two Smallpox vaccines available in the US. One in an injectable vaccine and the other is an intradermal (superficial skin) vaccine.

Currently the Smallpox vaccine is only available through local health departments to those with known Monkeypox exposure or at high risk for exposure.

Depends on risk factors and health department recommendations.

Local health departments are the only health providers who have access to the vaccines. They will only offer vaccine if they believe it is necessary. At this time, the health department is only vaccinating those with known exposure or at high risk based on their evaluation in limited areas.

If it has been more than 3 years since you were vaccinated with the Smallpox vaccine, you should receive a booster dose of vaccine if you have been exposed to Monkeypox or are at high risk of exposure to the virus. Whether you qualify to receive the vaccine is determined by the local health department and not the university.

While those over 50 are likely to have received the Smallpox vaccine, it is recommended that if it has been more than 3 years since you were vaccinated, you get vaccinated again. The United States stopped vaccinating against Smallpox in 1972 after it was eradicated in the United States. Individuals vaccinated prior to 1972 will have a small scar on the outside of their left shoulder indicating that they have been vaccinated.

Disinfection Instructions

Use an EPA-registered disinfectant, in accordance with the manufacturer’s instructions. Follow all manufacturer directions for use, including concentration, contact time, and care and handling. For a list of EPA approved disinfectants please follow this link: https://www.epa.gov/pesticides/epa-releases-list-disinfectants-emerging-viral-pathogens-evps-including-Monkeypox

  • If you are not infected and need to decontaminate your home because of a roommate or family member having Monkeypox be sure to wear gloves when handling clothing or bedding prior to laundering.
  • Check that your product is EPA-registered: Find the EPA registration number on the product.
  • Read the directions: Follow the product’s directions. Check “use sites” and “surface types” to make sure this is the right product for your surface. Next, read the “precautionary statements.”
  • Pre-clean the surface: Make sure to wash the surface with soap and water if the directions mention pre-cleaning or if the surface is visibly dirty. Dirt can keep the disinfectant from working.
  • Follow the contact time: Follow the instructions: The surface should remain wet for the amount of time indicated to ensure the product is effective. Reapply if necessary.

You may download our disinfection guide here.

Individuals who have confirmed diagnosis of Monkeypox should isolate until all the scabs have fallen off and new intact skin have replaced the scabs. This may take 2-3 weeks.

If you believe you have Monkeypox, please contact Campus Health Services, your local health department, or your healthcare provider for assistance so you can be evaluated and tested if appropriate. Currently, the only available testing for Monkeypox is through local and state health departments CDC or major commercial laboratories. Recently, Quest Diagnostics began offering Monkeypox testing nationwide.

People with Monkeypox should isolate until rash has fully resolved, the scabs have fallen off, and a fresh layer of intact skin has formed. Please download this isolation guide for more information.

There have been reports of infected animals being imported into the US that have caused Monkeypox outbreaks. Alternatively, infected individuals could potentially transmit the infection to household pets such as dogs or cats. Once diagnosed with Monkeypox, the individual should avoid contact with their pets until all the scabs have fallen off.

Yes. Anyone can contract the virus, including children and pets (mammals).

No. You cannot return to class until all of the scabs have fallen off exposing healthy skin. You must be cleared by Campus Health Services before you can return to campus or be released from isolation.

Please reach out to Contact Tracing at tracing@louisville.edu or Campus Health Services at 852-6479 for guidance.

Please reach out to Contact Tracing at tracing@louisville.edu or Campus Health Services at 852.6479 for assistance.

At present, vaccination is being offered to presumed contacts who may meet the following criteria:

  • Know that a sexual partner in the past 14 days was diagnosed with monkeypox
  • Had multiple sexual partners in the past 14 days in a jurisdiction with known monkeypox

It is expected that a limited number of vaccine doses will be available for individuals who are high risk for contracting monkeypox virus in the coming several weeks and months. The vaccine is only available through local health departments.

Monkeypox

Stay Safe. Stay Healthy.

Monkeypox Support Team

 

Can't find the information you need?  Contact the Monkeypox Support Team

Open Monday through Friday from 8AM to 5PM

Call 502-842-7549, email , or

start a live chat session

Live Chat

The University is constantly assessing the Monkeypox situation nationally as well as locally and is responding accordingly.  We will update this site periodically, should the need arise.  

About Monkeypox

Monkeypox is usually a rare disease caused by the Monkeypox virus and is typically seen in Central and West Africa.  Recently, the virus is behaving in ways that scientists haven't seen before.  Cases have been reported in countries all over the world.  Traditionally Monkeypox was not easily spread to other people or able infect large groups of people.  

Most cases of Monkeypox from the current outbreak have been in young men who are mostly having sex with other men although anyone who has close contact  can potentially get it.   

Current US Outbreak Information

Current US Monkeypox outbreak information is available by clicking the map below:  


Monkey Pox FAQs

Please see our Monkeypox FAQs for specific information regarding Monkeypox.   


Guides and Handouts

Monkeypox FAQs

Monkeypox Disinfection Guide 

Monkeypox and Social Events Guide 

Monkeypox Safer Sex Guide


Videos 

VIDEO CDC 5 Things You Should Know About Monkeypox


CDC Resources 

Monkeypox  Home Page