Belleville High School
RAHS-Belleville High gives Tiger Nation teens the tools they need to live a healthy and happy lifestyle. The clinic helps provide immunizations, health education, and behavioral health counseling for youth 21 years old and younger regardless of insurance status or ability to pay. Stop by and talk to us!
What's on site at Belleville High School:
- General physical exams
- Sports physicals
- Sick care
- Dental care
- Immunizations
- Lab tests
- Risk assessments
- Counseling (individual, group, and family)
- Asthma and other chronic conditions care
- Referrals to community resources
- Medicaid enrollment assistance
- Insurance enrollment
- Interpreter services available
Location
Belleville High School
501 W. Columbia Ave.
Belleville, MI 48111
(734) 998-2163
(734) xxx-xxxx
Hours
Staff at RAHS Belleville High School
Medical Assistant
Dr. Stephen Park, MD
Clinical Provider and Co-Medical Director
Dr. Kelly Orringer, MD
Clinical Provider and Co-Medical Director
Clinical Social Worker
Forms
Using the RAHS Health Center is easy! Find the registration form you need below, complete it, and send it or bring it with you to the health center at your school, or the school nearest you. Call to schedule an appointment in advance. Registration forms are also available at each of the health centers.Pediatric Registration and Consent Forms
- Pediatric Registration and Consent Forms: Read the registration packet requirements and review the Notice of Privacy Practices. Print and complete the forms and send the completed packet to RAHS-Belleville High school-based health center or fax to (734) xxx-xxxx.
- Pediatric Registration and Consent Forms – en Espanol: Lean la Carta de Bienvenida para cumplir con los requisitos de inscripcion y revisen los documentos de Notificacion sobre Politicas de Privacidad de UMHS. Impriman las pagina 2 a la 9, Ileneen los documentos y regresenios via fax al (734) xxx-xxxx.
- Pediatric Registration and Consent Forms – Arabic
- Pediatric Registration and Consent Forms – Farsi
- Pediatric General Consent for Healthcare – French: Lisez et examinez ce consentement général pour les services de santé et les informations importantes sur les patients. Imprimez et remplissez les formulaires et envoyez le dossier complété au centre de santé scolaire RAHS-Belleville High School ou par fax au (734) xxx-xxxx.
- Pediatric Registration and Consent Forms – Swahili: Soma na uhakiki Idhini hii ya Jumla kwa Huduma za Afya na Taarifa Muhimu za Mgonjwa. Soma na uhakiki Chapisha na ujaze fomu na utume pakiti iliyojazwa kwa kituo cha afya cha shule ya RAHS-Belleville High School au faksi kwa (734) xxx-xxxx.
Sports Physical Exam Clearance & Consent Forms
Print the two-page form. Complete and sign consent. Return the completed packet to RAHS-Belleville High health center or fax to (734) xxx-xxxx.
Patient Rights and Responsibilities and After Hours Care
What you can expect from your school-based health center, as well as how to get help when the RAHS Health Centers are closed.
Notice of Privacy Practices
- Notice of Privacy Practices - English: Confidentiality and security practices of UMHS and RAHS.
- Notice of Privacy Practices – En Español
- Notice of Privacy Practices – Arabic
- Notice of Privacy Practices – French
- Notice of Privacy Practices – Other available languages
Adult Registration and Consent Forms
- Adult Registration and Consent Forms: Read the welcome letter for registration requirements and review the Notice of Privacy Practices. Print pages 2-9. Complete each form and send the completed packet to RAHS-Belleville High school-based health center or fax to (734) xxx-xxxx.
- Adult Registration and Consent Forms – en Espanol: Lean la Carta de Bienvenida para cumplir con los requisitos de inscripcion y revisen los documentos de Notificacion sobre Politicas de Privacidad de UMHS. Impriman las pagina 2 a la 9, Ileneen los documentos y regresenios via fax al (734) xxx-xxxx.
- Adult Registration and Consent Forms – Arabic
- Adult Registration and Consent Forms – Farsi
- Adult General Consent for Healthcare – French: Lisez et examinez ce consentement général pour les services de santé et les informations importantes sur les patients. Imprimez et remplissez les formulaires et envoyez le dossier complété au centre de santé scolaire RAHS-Belleville High School ou par fax au (734) xxx-xxxx.
- Adult Registration and Consent Forms – Swahili: Soma na uhakiki Idhini hii ya Jumla kwa Huduma za Afya na Taarifa Muhimu za Mgonjwa. Soma na uhakiki Chapisha na ujaze fomu na utume pakiti iliyojazwa kwa kituo cha afya cha shule ya RAHS-Belleville High School au faksi kwa (734) xxx-xxxx.
Additional Services for Minors
Please ask your health center about these services.
- Minor Consent for Confidential Services: Read and review the Notice of Privacy Practices (above). Read and review this Minor Consent for Confidential Services. Download and complete the form as directed by health center staff.
- Consentimiento de menores para servicios confidenciales: Lea y revise el Aviso de prácticas de privacidad (arriba). Lea y revise este Consentimiento de menores para servicios confidenciales. Descargue y complete el formulario según las indicaciones del personal del centro de salud.
Belleville High School
- 501 W. Columbia Ave.
Belleville, MI 48111