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Staff and Dependents of the ¾ÅÉ«ÊÓƵ (UEW) who receive medical care outside the ¾ÅÉ«ÊÓƵClinics without a referral from the Clinics and who require feedback reports do not necessarily have to pick feedback forms from ¾ÅÉ«ÊÓƵClinics. Feedback forms can now be downloaded from the ¾ÅÉ«ÊÓƵwebsite and given to the Physician who attended to your emergency for completion to support your medical refund claims. 

Staff and dependents should note that non-emergency referrals would be obtained from the University Clinics after appropriate assessment. 

To obtain the Medical Feedback form, please go to

1. Policies and Forms
2. Click on University Clinic from the right sidebar
3. Locate Medical Form from the list and click on download.

You can also click on the link below to download the form

Medical Feedback Form