SHWC Online Inquiry/Request Form

Online Inquiry/Appointment Request Form

If you're experiencing a life threatening medical emergency, STOP! Dial 9-1-1.
This form can be completed to request an appointment with Student Health on any USF campus or to ask a question.

THIS FORM IS NOT TO BE USED FOR SAME DAY APPOINTMENTS:

Instead Please call (813) 974-2331 Option #2 - Mon - Fri 8am to 5pm

Tampa Student Health & Wellness Center

12530 USF Bull Run Drive, Tampa FL 33620

St. Petersburg Wellness Center

140 7th Avenue South, SLC2200. St Petersburg, FL 33701

Sarasota-Manatee Counseling & Health Center

8350 North Tamiami Trail, SMC 0107A, Sarasota, FL 34243

CAMLS Medical Group

124 S Franklin St, CAMLS Suite 323, Tampa, FL 33602

We are closed on weekends and USF Observed Holidays/Closures (see below):

* Juneteenth Day - Friday, June 19, 2026

* In Observance of 4th of July - Friday, July 3, 2026

* Labor Day - Monday, September 7, 2026

* Veterans Day - Wednesday, November 11, 2026

* Thanksgiving Observed - Thursday& Friday, November 26 & 27, 2026
Full Name

First (Given) Last (Family)
Student U# or Employee ID#
Email Address

Confirmation Email
Cell/Mobile #
Please select one
Question(s)
Complete all remaining fields of the form below if you are requesting a medical appointment. As a result of the American Recovery and Reinvestment Act, the USF Student Health and Wellness Center is required to collect patient data regarding race, ethnicity, and language as part of the information provided to the Centers for Medicare & Medicaid Services (CMS). This information is required for all patients.

Please note: you have not been scheduled until you receive an email confirming the date and time of your appointment.
Birth Date

MonthDayYear
Gender
Marital Status
Ethnicity
Race
Preferred Language
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Preferred location for your appointment
CAMLS Clinic access is limited, please select your student classification
Reason for the appointment (your primary complaint)
Do you have insurance?
Upload Insurance Card (front/back)

Browse Files

Cancelof
Insurance Company Name
Insurance Company Claims Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Insurance Company Phone Number
Member ID/Policy #
Member Group ID #
Insurance Type
Insurance Policy Holder’s Name

First NameLast Name
Relationship to Policy Holder’s
Policy Holder Date of Birth

MonthDayYear
Insurance Policy Holder’s Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Insurance Policy Holder’s Phone Number
Have you been to the clinic before?
Preferred appointment day
Preferred appointment time
Please select preferred appointment time ranges for GYT
Will this visit be related to an injury?
If yes, were you at work when the injury occurred?
Do you want to reschedule?
Select the date/time of the appointment you are rescheduling/canceling

MonthDayYear
Date
:HourMinutesAM/PM Option
You will be assessed a fee for missed appointments (i.e. No Shows), late cancellations or late arrivals.

Cancellation requests received after 12pm (noon), the business day before the scheduled appointment time will be subject to this fee.

Please note: Dermatology appointments are limited and therefore the patient must cancel by noon two business days prior to avoid the fee.
Should be Empty:

Online Inquiry/Appointment Request Form