Health, Physical Education, and Recreation
Physician Referral Form

 

 

Please print this letter and complete the patient parts and have your personal physician complete the form.

The pdf of this form is available here.

If you have any questions, please call the Wellness Testing Center at 782-5114.


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For more information contact:  

Jacksonville State University
Department of HPER
700 Pelham Road North
Jacksonville, AL 36265
(256) 782-5515 or
1-800-231-5291
hper@jsu.edu