Forms

Many of our most highly used forms are available for you to complete before your appointment. It is not mandatory that these forms are completed in advance. It is simply a way to speed up your visit, as we know students are busy!

Authorization for Release of Healthcare Information (Medical Records Request)

Consent for Services and Communication Form

Iowa State University Notice of Privacy Practice for Patients Form

Insurance Information Form

Sliding Fee Discount Program Application

Gynecological History Form

Traveler History Form

Consent for Verbal Communication

Revocation of Authorization of Release of Healthcare Information or Consent for Verbal Communication

Submit forms to the Medical Records Department at shcreco@iastate.edu, by fax at 515-292-9135, or by mail by addressing the from to Medical Records, 2647 Union Drive, Iowa State University, Ames, IA 50011-2029.

Click here for more information on requesting your medical records.

 

Job Shadow Application for High School and College Students. Please complete and email to cyclonehealth@iastate.edu

 

Policies

Iowa State University Thielen Student Health Center is governed by the policies of Iowa State University. Although there are numerous policies that apply to the health center, there are a few that are often referenced and therefore called out below.

Patient Rights

Each patient has the right to:

  • Ask questions about my treatment.
  • Choose among Thielen's healthcare providers and change providers, if available.
  • Be informed about my diagnosis, evaluation, treatment options and prognosis; participate in healthcare decisions except when the participation is contraindicated for medical reasons.
  • Continuity of healthcare between Thielen, hometown, and consulting healthcare provider.
  • Request a second opinion from a healthcare provider or mental health professional.
  • Appropriate privacy and, if requested, a chaperone.
  • Information about services provided, my eligibility for those services and fees and payment options.
  • Information about how to seek care after hours and in emergencies.
  • Private, confidential, and secure medical records.
  • Information about the credentials of Thielen healthcare providers and consultants.
  • Submit grievances regarding treatment or care that is, or fails to be, furnished.
  • Treatment with respect, consideration, dignity, and without discrimination or bias based on the basis of protected class status.
  • Terminate treatment at any time.
  • Right to receive a cost estimate
  • Protection from surprise medical bills

Refunds/Cancellations

All memberships and locker services are non-refundable except under the following circumstances:

  • Member has a documented medical or health condition that will not allow them to use the facility
  • Member will be on military deployment
  • Member is faculty/staff who is no longer employed by the university
  • Member is faculty/staff with a change in employment status (i.e. shift change or newly assigned remote work)

Cancellations

Not all memberships are eligible for cancellation. Only members on an annual month-to-month membership are eligible to cancel the unused portion of their membership if the following criteria are met:

  • Annual month-to-month membership: After Cancellation/Refund Request Form is received and approved, membership will be cancelled at the end of the same month the request is received. Example: cancellation request received April 10th; membership ends on April 30th

Cancellation/Refund Request

  • A Cancellation/Refund Request Form must be completed and any request. Any applicable documentation must be provided to request a cancellation or refund
  • Upon approval, a refund will be processed within 7-10 business days
  • Approved refunds will be processed on a prorated basis and refunded back via the original method of payment

Activities in Designated Spaces 

  • No type of exercise or physical activities are allowed in hallways or walkways. 

Aquatics - Beyer Hall Pool Policies 

  • DO NOT enter the pool unless a lifeguard or qualified instructor is present. 
  • Only “Lap Swimming” is allowed in Beyer Pool (Aua Jogging is allowed in the Diving Well). 
  • No diving into the lanes or in other areas marked “NO DIVING. 
  • No running on the deck or pool enclosure area. 
  • No horseplay in or around the swimming pool. 
  • No back dives, back flips or front flips allowed. 
  • Swimming lessons are prohibited in the pool without permission of Recreation Services. 
  • Use of diving boards, starting blocks and trampoline are prohibited during informal recreation swim. 
  • Use of the swimming pool by anyone with a contagious disease or open sore is prohibited. 
  • Please remove all band-aids before entering the water. 
  • No food or beverage allowed (NO GUM). 
  • Do not swim after the consumption of alcoholic beverages. 
  • Lane lines, handicap chair, time clock, radio and other pool equipment are to be handled only by the lifeguard staff. 
  • For your convenience, swimming lanes are designated Fast, Medium, and Slow. Please choose a lane according to your ability. Lifeguards reserve the right to move patrons if necessary. 
  • Non-Coast Guard approved flotation devices are prohibited. These include, but are not limited to; water rings, water wings, unapproved life jackets and inner tubes. 
  • Recreation Services is not responsible for lost, stolen, or damaged personal property. 
  • Decisions rendered by the lifeguard staff are final. 

Lap Swimming Etiquette 

For the Health and Enjoyment of all swimmers, please abide by the following: 

  • Expect to share a lane.  If there are 3 or more swimmers, you must circle swim. 
  • Try to swim with others of your own pace. 
  • Swim in a counterclockwise direction staying on the right side of the lane. 
  • Pass only when the passing lane (middle of lane) is clear. 
  • Avoid congregating at the end walls.  Please move to the extreme right corners of the lane if stopping for a moment. 
  • Be considerate of others and their individual workouts. 

Aquatics-State Pool Policies  

  • DO NOT enter the pool area unless a lifeguard or qualified instructor is present.  
  • Swimsuits must be worn; street clothing is not allowed in the water (t-shirts are allowable).  
  • No food or beverage allowed (NO GUM).  
  • No diving into the shallow areas (lanes, vortex or spa) or in other areas marked          “NO DIVING.”   
  • Jumping from the deck to the play area is not allowed.  
  • No running on the deck or pool enclosure area.  
  • No rough play in or around the swimming pool.  
  • Swimming lessons are prohibited in the pool unless scheduled   
  • Use of the swimming pool by anyone with a contagious disease or open sore is prohibited.  
  • Please remove all band-aids before entering the water.  
  • Do not swim after the consumption of alcoholic beverages.  
  • Lane lines, handicap chair, time clock, radio, television and other pool equipment are to be handled only by the lifeguard staff.  
  • Hanging on the backboard, rim (dunking) or volleyball nets prohibited.    
  • Non-Coast Guard approved flotation devices are prohibited.    
  • Recreation Services is not responsible for lost, stolen, or damaged personal property.  
  • Decisions rendered by the lifeguard staff are final.  

3 Meter Platform Policies  

  • One person at a time – next diver must wait on the pool deck until the person has gone off the platform.  
  • No handstands, back flips or cartwheels are allowed.  
  • Go straight off the board and exit the water immediately (stairs located on the east side of diving well).  
  • The use of goggles or masks while diving is prohibited (can be placed on the wrist while diving).  

Spa Policies  

  • Persons with a medical condition, including pregnancy, should not use the spa without first consulting with a physician.  
  • Anyone having a contagious disease shall not use the spa.   
  • Persons shall not use the spa immediately following exercise or while under the influence of alcohol, narcotics, or other drugs.   
  • Persons shall not use the spa alone or without supervision.   
  • Children shall be accompanied by an adult.   
  • Persons shall not use the spa longer than ten minutes.   
  • No one shall dive or jump into the spa.   
  • A maximum of 25 people are allowed in the Spa at one time.  

Lap Swimming Etiquette  

For the Health and Enjoyment of all swimmers, please abide by the following:  

  • Expect to share a lane.  If there are 3 or more swimmers, you must circle swim.  
  • Try to swim with others of your own pace.  
  • Swim in a counterclockwise direction staying on the right side of the lane.  
  • Pass only when the passing lane (middle of lane) is clear.  
  • Avoid congregating at the end walls.  Please move to the extreme right corners of the lane if stopping for a moment.  
  • Be considerate of others and their individual workouts.  

Assumption of Risk 

By participating in activities or using equipment and facilities offered by ISU Recreation Services, patrons knowingly and voluntarily ASSUME ANYAND ALL RISK of injuries, regardless of severity, which may occur as a result of participation in aquatics, sport clubs, group fitness, intramurals, outdoor recreation (climbing or bouldering wall), self-directed exercise and/or other activities provided by Recreation Services. Recreation Services is not responsible for lost or stolen items.  

 

IOWA STATE UNIVERSITY OF SCIENCE AND TECHNOLOGY 

RECREATION SERVICES  

ASSUMPTION OF RISK, WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT  

In consideration for being permitted to participate in Iowa State University Recreation Services’ Reopening (the “Reopening”) and utilize Iowa State University Recreation Services’ (“Recreation Services”) facilities, equipment, services and programs, the undersigned, on behalf of themselves and any personal representatives, heirs, assigns, and next of kin (“Participant”), HEREBY ACKNOWLEDGES, AGREES, AND WARRANTS THAT: There is a risk of serious injury to me while using Recreation Services’ facilities, equipment, services and programs.  Every activity, including but not limited to rock climbing, group fitness classes, weight and cardio equipment, swimming, and general physical activity, has a certain degree of risk. By voluntarily participating in activities and utilizing Recreation Services’ facilities, equipment, services and programs, Participant knowingly and voluntarily ASSUMES ALL RISKS of injuries, including the risk of serious illness, disability, and/or death, which may occur as a result of my participation in the use of Recreation Services’ facilities, equipment, services and programs; 

  • Participation in the Reopening and/or the use of Recreation Services’ facilities, equipment, services, or programs includes possible exposure to and illness from infectious diseases, including but not limited to COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness, disability, and/or death does exist and cannot be eliminated. If Participant elects to participate in the Reopening and/or use ISU’s facilities or services, Participant ASSUMES ALL RISKS associated with participation; 
  • Due to the nature of the Reopening and the facilities, services, and programs offered by Recreation Services, social distancing of six (6) feet per person may not be possible to implement and enforce;   
  • Participant has adequate health insurance to cover any injury or damages that I may suffer while participating, or alternatively, agree to pay all costs associated with any such injury or damages; 
  • Participant is in sufficiently good health and has no symptoms that could interfere with Participant’s safety or the safety of others while participating.  Participant understands and agrees that they alone are responsible for determining whether they are fit to participate. 
  • Participant agrees to abide by all applicable rules and codes of conduct. Participant understands and agrees that any unpaid balance including collection and administrative fees are Participant’s responsibility.   
  • Participant, on behalf of themselves and any personal representatives, heirs, assigns, and next of kin, HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE, the State of Iowa; the Board of Regents for the State of Iowa; Iowa State University; and all of their respective officers, employees, student workers, student interns, volunteers, agents, and/or departments (the “Releases”) from any and all liability, claim and/or cause of action arising out of or related to any loss, damage or injury, including death, that may result from, arise out of, or be related to Participant’s participation in the Program including, but not limited to, the use of Recreation Services’ facilities, services or programs equipment, to the fullest extent permitted by law; 
  • In addition, Participant, on behalf of themselves and any personal representatives, heirs, assigns, and next of kin, HEREBY AGREES TO INDEMNIFY AND HOLD HARMLESS the Releasees from any and all liability for injury, including illness, disability, and death, and property loss or damage that may result from, arise out of, or be related to Participant’s participation in the Reopening including, but not limited to, the use of ISU facilities, equipment, services or programs, to the fullest extent permitted by law; 

Attire Policy 

Recreation Services strives to maintain a clean, safe, and inclusive environment while honoring personal workout clothing preferences. 

  • Shirts/tops and shorts/pants must be worn at all times other than in the pool and locker rooms. 
  • Appropriate, clean, closed-toe, non-marking, athletic shoes are required in all activity areas unless otherwise directed by Recreation Services staff.  Street shoes or shoes that mark the floors are prohibited. An athletic shoe is defined as follows: a shoe designed to be worn for sports, exercise, or recreational activities.  
  • Clothing cannot display offensive language.  
  • Clean attire intended for swimming must be worn in the pool and hot tub (no workout clothes).   
  • Gender-specific attire is not required within any of our recreation facilities. Participants are encouraged to wear attire that most honors their workout experience.  

Beyer Hall Athletics 

Athletics 

  • ISU Student Athletes must show a valid ISUCard and swipe into the facility. 
  • Spectators associated with ISU Athletic Events will be allowed access through the main southwest entrance.   
  • Facility access for spectators is limited to the event venue and restrooms only. 
  • University employees conducting business will be granted access. 
  • Visitors need to enter through the main southwest entrance and state their business. 

Camps / Clinics 

  • Participants' and coaches' access will be through the main southwest entrance.  Camp/Clinic participants must be under the supervision of the Team Camp staff and are allowed in only areas that are reserved for the event. 

Beyer Hall Sport Clubs Storage Access 

Club Storage Cages Room 1500 

Clubs that have storage cages/cabinets in Beyer Hall Room 1500 need to follow this procedure to access those areas: 

  • Go to the Beyer Hall Service Center Desk at the main entrance. 
  • Inform the Beyer Attendant which club they represent, and the area needed to access. 
  • A Beyer Attendant will accompany the club to the area and allow the club entrance into the space.  Each club will have a key checked out to them to access their club cage/cabinet. 
  • Once the club leaves this area they need to ensure the door is locked behind them. 
  • The club should notify the Beyer Attendant at the Service Desk that they are done accessing that area. 

Beyer Hall Multipurpose Room 3430 

Multipurpose Room 3430 

This space is used on a reservation only system.  This area is locked and secured unless a group has it reserved.  Groups need to follow this procedure to access this area: 

  • Clubs/Groups need to reserve the space by filling out an online Facility Reservation Form at www.recservices.iastate.edu under the facilities tab.  

  • During scheduled reservations go to the Beyer Hall Service Center Desk at the main entrance. 

  • Inform the Beyer Attendant which club/group they represent and the area they need to access. 

  • A Beyer Attendant will accompany the club/group to the area and allow them entrance into the space.   

  • Once the scheduled time is completed the club/group needs to vacate the space. 

Bicycles, scooters, in-line skates and skateboard and policies 

  • Bicycles, scooters, in-line skates and skateboards of any style, are prohibited from being used inside Recreation Services facilities.  
  • These items must not cause any obstructions or a hindrance to patrons.   

Bulletin Boards, Banners, Flyers and Postings 

  • There are no public bulletin boards located in Recreation Services facilities.  

  • Postings may not be affixed to walls, windows, doors, or other surfaces unless approved by Recreation Services. 

  • All tabling, banners, flyers, or other signage must be pre-approved by Recreation Services.  

  • All material must be related to the Student Health and Wellness Unit.  

  • Recreation Services reserves the right to remove any material at any time.  

Tabling 

  • All tabling must be pre-approved by Recreation Services. 

  • Activity being promoted must be related to ISU sponsored/endorsed activities; i.e. Student organizations, academic units, etc. 

  • Material must not be offensive and appropriate for public viewing. 

  • Recreation Services reserves the right to cancel tabling arrangements or ask tabling organization to leave at any time 

Conduct & Disciplinary Policy 

All Recreation Services users are expected to be responsible, courteous, and safety-conscious at all times.  Disorderly conduct, abuse of staff, misuse of the facility or its equipment, or disregard for policies will not be tolerated.  Violators will be required to leave the facility and may be subject to disciplinary action.  Usage privileges may be revoked or suspended for policy violation at any time.   

Users who are suspended will not have any portion of their fees refunded. 

Each incident is reviewed on a case-by-case basis with appropriate disciplinary actions handed out.  Additional disciplinary actions may be taken by the Office of Dean of Students Judicial Affairs. 

Policies are posted on site and located at specific areas throughout the recreation facilities.  All Recreation Services policies can be located on our website. All policies outlined in the Student Disciplinary Regulations (Code of Conduct) will be enforced. The Student Disciplinary Regulations (Code of Conduct) can be found on the ISU Website under the Policy Library.   

Entry 

  • All users must present a valid ISUCard upon entry or be sponsored by a member and purchase a daily guest pass. 
  • The Recreation Services app may be used in place of an ISUCard. 
  • Recreation Services reserves the right to refuse admittance.   
  • Upon request an ISU ID or pass must be shown to staff. 
  • Entry to and exit from the facility must be through controlled access points only.  
  • Other exits should be used for emergencies only.   

Fitness Area Policies 

  • Users are to abide by the facility attire policy. Shirts/tops, shorts/pants, and athletic closed-toe shoes must be worn other than in the pool and locker rooms.  See ATTIRE POLICY 
  • Large items like bags, backpacks, and clothing are to be stored outside the Fitness Area. 
  • Equipment will be first come, first served with a maximum of 30 minutes.  
  • Food, gum, tobacco products or open beverage containers are prohibited. 
  • Mixing of supplements in the weight room area is prohibited. 
  • Gym chalk is prohibited. 
  • Saving equipment is not permitted with personal belongings and or fitness equipment.  
  • Re-rack weight plates and dumbbells in the proper place when finished. 
  • Cubbies are for storage only.  
  • Do not set weights on cubbies or use them for exercise.  
  • Do not neglect or misuse any of the equipment. 
  • Do not place weights on benches. 
  • Dropping weights or cable stacks is prohibited.  
  • Weight must be controlled throughout the entire movement. 
  • Collars must be used on all barbell lifts.  
  • Wipe down equipment after use. 
  • Personal training or private instruction is restricted to those employed by Recreations Services. 
  • Recreation Services is not responsible for lost or stolen items. 
  • Users are to abide by all staff requests. 

Gymnasium & Court Policies 

  • Intramurals, Sport Clubs, Campus Organizations, University Affiliations and groups with advanced reservations approved through the Recreation Services scheduling office have priority over all other groups. 
  • Racquetball and squash court participants are given priority over other activities in those designated courts. 
  • Non-university groups conducting organized practices may ONLY use the courts on a space-available, hourly rental basis. Details available at Recreation Services central administrative offices. 
  • No type of sports activity is allowed in hallways or walkways.  
  • Users are to abide by the facility attire policy. Shirts/tops, shorts/pants, and athletic closed-toe shoes must be worn other than in the pool and locker rooms.  See ATTIRE POLICY 
  • Hanging from rims or nets is prohibited.  
  • Bicycles, scooters, in-line skates and skateboards of any style, are prohibited from being used inside Recreation Services facilities. 
  • The use of audio devices is restricted to Recreation Services staff.  Please use headphones/earbuds to listen to your audio content. 
  • Animals are not permitted in facilities except trained service animals. Companion animals are not allowed. 
  • Only non-alcoholic beverages in closed, re-sealable plastic containers are allowed in activity areas. Gum, tobacco and alcoholic beverages are not allowed. Food is not allowed unless permitted otherwise. 
  • Solicitation, private classes, personal training, or any other activity associated with personal gain is not permitted. 

Indoor Lied 3rd Floor Track Policy 

  • Runners use inside lanes, walkers use outside lanes 
  • No more than two people together side-by-side. 

  • 1 Mile = 5.5 Laps 
  • (about .18 miles per lap) 

Track Direction:  Counterclockwise 

Lied Upper Track  

  • 1 Mile =  5.5 Laps 
  • (about .18 miles per lap)  
  • Counterclockwise Only 

Indoor State Gym East Track Policy 

  • Runners use inside lanes, walkers use outside lanes 
  • No more than two people together side-by-side 
  • 1 mile = 12 laps 
  • (About .083 miles per lap) 

Track Direction:  Counter Clockwise Monday, Wednesday, Friday, Sunday Clockwise Tuesday, Thursday, Sunday 

Indoor State Gym West Track Policy 

  • Runners use inside lanes, walkers use outside lanes 
  • No more than two people together side-by-side. 
  • 1 Mile = 8 Laps 
  • (1/8 miles per lap) 

Track Direction:  Counterclockwise 

Lied Rec Center Policy 

  • The Athletic Department has priority over the main floor area in the Lied Recreation Athletic Center Monday – Friday from 2 PM – 6 PM and Saturday from 8 AM- Noon during the fall and spring semesters. 
  • In the Lied Recreation Athletic Center, footballs are permitted on the turf, but cannot be kicked or punted. 
  • Sports such as but not limited to baseball, softball, cricket, golf, lacrosse and soccer are limited to only the Lied Recreation Athletic Center during scheduled reserved club times or during morning hours when other patron’s safety is not at risk from the activity.  Facility Supervisors will make this decision and at any time may end the activity. 
  • Sport Clubs may practice during scheduled times with limits to control play in a safe manner. 
  • Stroller Policy – Patrons with young children may walk with their child in a stroller on the lower track of the Lied Recreation Athletic Center. 
  • Monday-Friday  8am-noon (if there are no other scheduled activities) 
  • Children must always be in the stroller. 

Locker Rentals 

  • Lockers in the locker rooms of Beyer Hall, the Lied Recreation Athletic Center, and State Gym may be rented monthly, semesterly, or annually,  
  • Locker rental dates are the same as membership dates. 
  • Recreation Services will provide locks for every locker in our locker rooms. 
  • Personal locks will be cut off and contents removed daily on rented or day use lockers.  Contents may be retrieved from Recreation Services service desks. 
  • Locker renewal may be done in person or online. In person renewals may be done at State Gym during Business Hours.   
  • Locker cleanout dates for expired lockers vary per person. Each member will receive email reminders when their locker is about to expire. 
  • Recreation Services is not responsible for lost or stolen property. 

Locker Rooms & Restroom, Policies 

  • Recreation Services patrons may use facilities including locker rooms and restrooms consistent with their gender identity. 

  • Taking pictures or videos is strictly prohibited. 

  • Do not leave valuables unsecured or unattended. 

  • Recreation Services is not responsible for lost, missing or stolen property. 

  • Lost and found articles may be taken to the service desk or to the main office.  

  • Please notify the Building Supervisors of any needs you may have, unsafe activities or facility problems immediately.   

  • Personal locks are not to be used at any time and will be cut off daily. 

  • Children Dressing Area Policies 
  • Children 6 years of age and older must use their gender-identifying restroom. 
  • Children under 6 may use any restroom under supervision of their parent/guardian/sponsor. 

Day Locker  

  • Are available for short term- single day usage. 
  • Overnight storage of personal belongings is not allowed. 
  • Contents will be removed at closing time. 
  • Contents can be recovered the following working day at the front desk. 
  • After 30 days the contents will be sent to Access Recovery for disposal. 
  • Recreation Services is not responsible for lost or stolen property. 

Lost & Found 

  • Lost and found items such as small valuables, ID cards, clothes, equipment and other miscellaneous items may be turned into a Recreation Services Front Desk and will be secured by the Facility Supervisor on duty.   
  • Lost and found items will be stored in secured locations until either claimed or turned over to Asset Recovery.  
  • Recreation Services is not responsible for lost or stolen items. 

Lost ISU Cards 

  • The ISU Card verifies your status as an ISU student, faculty or staff member and provides access to university services and facilities, such as Recreation Services facilities and programs. 
  • Lost cards may be replaced by going to the ISU Card Office at 0530 Beardshear Hall - 515-294-2727.  Their regular business hours are 8:00 AM – 4:30 PM. 

  • Immediately report the loss of your ISU Card in AccessPlus under ISU ID's or to the ISU Card office, 0530 Beardshear Hall, (515) 294-2727. A replacement card will be issued for a fee. 

  • If you have a new card you must update your card with Recreation Services Administration office located at 1180 State Gym. 

Non-Discrimination – Accessibility Policy 

  • Iowa State University and the Department of Recreation Services does not discriminate on the basis of race, color, age, ethnicity, religion, national origin, pregnancy, sexual orientation, gender identity, genetic information, sex, marital status, disability, or status as a U.S. Veteran. Inquiries can be directed to the Office of Equal Opportunity and Compliance, 3350 Beardshear Hall, (515) 294-7612. 

  • Recreation Services is committed to assuring that its facilities, programs, or services are free from discriminatory, inappropriate, and disrespectful conduct or communication. 

  • Verbal or written abuse, threats, intimidation, violence, or other forms of harassment towards participants or staff will not be tolerated. 

  • All participants and staff are expected to respect the rights of others and to be civil, effective citizens of the ISU community. 

  • Recreation Services patrons may participate in programs and use facilities consistent with their gender identity. 

  • Facilities operated by Recreation Services are in compliance with the Americans with Disabilities Act. Our staff is eager to provide assistance when needed. We want all our patrons to fully use our facilities and reach their health and fitness goals. 

 

Outdoor Field Policy 

  • Southeast Recreational Complex, Maple Willow Larch (MWL) Fields, Southwest Recreation Complex and Lied Multipurpose Fields (formerly ISU Soccer Field) are reserved for Intramural and Sport Club activities. These fields may also be used by non-university groups if they have not been reserved by ISU affiliated organizations. Reservations can be made by contacting Doug Arrowsmith at 294-0386 or by filling out an online facility reservation request form by visiting the ISU Recreation Services website at cyclonehealth.iastate.edu. 

  • ISU Recreation Services will make decisions pertaining to field and weather conditions and reserves the right to close the facility and/or cancel activities at any time. 

  • Lights will be programmed at the discretion of the department. 

  • Physical changes to the site are not allowed unless pre-approved by Recreation Services (i.e. moving bleachers or goals, installing items into the ground, etc.) 

  • Pets, glass containers, motorized vehicles, and any other unsafe items are prohibited. 

  • Tobacco and alcohol are prohibited. 

  • Vehicles are not allowed on the grass playing surfaces at any time. Parking is also prohibited on the grass playing surfaces. 

  • Groups are required to pick up any trash and are expected to dispose of it properly in trash receptacles. 

  • ISU Recreation Services can postpone or cancel activities at any time if the event is deemed unsafe; or if event coordinators, participants, or spectators are uncooperative or in violation of the policies. 

  • Violations of Recreation Services rules, Recreation Services program policies, or ISU student conduct policies, may lead to removal from the facility and loss of privileges. 

Personal Belonging Storage 

  • Personal belongings should be stored in dedicated lockers or cubbies.  
  • No personal belongings to be stored overnight. 
  • No personal belongings to be used to save equipment. 

Racquetball & Squash Courts 

  • Racquetball and squash court participants are given priority over other activities in those designated courts. 
  • Only clean, non-marking, athletic shoes intended for wood floors are allowed. 
  • Avoid striking the court walls and floor with racquets. 
  • For your safety, Recreation Services strongly recommends using a racquet equipped with a wrist cord and wearing protective eyewear. 
  • Removing equipment from the facility is not permitted.  
  • Please notify the Building Supervisors (515-294-2466) of any needs you may have, unsafe activities or facility problems immediately.  
  • Intramurals, Sport Clubs, Campus Organizations, University Affiliations and groups with advanced reservations approved through the Recreation Services scheduling office have priority over all other groups. 

Service Animal Policy  

Assistance animals are permitted on campus subject to the conditions and restrictions outlined within this policy.

All assistance animal accommodation requests made by students and visitors will be reviewed and assessed by Student Disability Resources (SDR) consistent with applicable laws and policies. All assistance animal accommodation requests made by employees will be reviewed by University Human Resources Employee Relations/Labor

Relations (UHR ER/LR). ISU reserves the ability to make special modifications, within the confines of applicable law, to its policies to reasonably accommodate the person requesting the accommodation. top

Emotional Support Animals on Campus: Only residents who have complied with this policy are permitted to have emotional support animals in their assigned university housing units. Residents wanting emotional support animals to reside in university housing must seek and receive approval pursuant to the Procedures and Guidance -

Assistance Animals on Campus (see Resources below) prior to the emotional support animal entering university housing. Only one emotional support animal will be permitted per resident and generally only one emotional support animal will be assigned per university housing unit. Emotional support animals are restricted to residential areas and are not otherwise permitted inside other university buildings, including, but not limited to: classrooms, dining facilities, recreational buildings, employment areas, libraries, sporting events, and research laboratories. Because emotional support animals are not trained to provide specific work or tasks, visitors and students not residing in university housing, faculty, and staff are generally not permitted to have emotional support animals on campus as a part of any disability accommodation. top

Service Animals on Campus: Service animals are generally permitted to accompany people with disabilities on all university properties where students, faculty, staff, and visitors are allowed, in buildings/facilities. A service animal’s access to certain areas on campus may need to be limited should the service animal’s presence create an undue hardship to the University. See the section on Exceptions and Exclusions below. Any such circumstances will be reviewed by SDR (for students and visitors) or UHR ER/LR (for employees) on a case-by-case basis.

All service animals must be housebroken (i.e., trained so that it controls its waste elimination, absent illness or accident) and must be kept under control by a harness, leash, or other tether unless the person is unable to hold those, or such use would interfere with the service animal's performance of work or tasks. In such instances, the service animal must be kept under control by voice, signals, or other effective means.

Students needing a service animal are encouraged to work with Student Disability Resources (SDR) prior to bringing the service animal to campus, to ensure reasonable accommodations are appropriately provided to the student. Students wishing to have their service animal reside with them in university housing will need to comply with this policy and the Procedures and Guidance - Assistance Animals on Campus (see Resources below).

Faculty and staff (or applicants for employment positions) needing a service animal are encouraged to contact UHR ER/LR prior to bringing the service animal to campus to ensure the disability accommodation request process is followed and reasonable accommodations are appropriately provided to the employee or applicant. Visitors with inquiries pertaining to service animals may contact either SDR or UHRER/LR. Visitors may consult the SDR and/or UHR ER/LR websites for additional details relating to process steps.

Further detail can be found on the ISU Policies Library. 

Social Media / Photography/ Video/ Cell Phone 

  • The Recreation Services Department takes photographs, video, and/or tape recordings of our various programs, activities, or special events. Photographs or video/audio recording may be taken of you. Unless you request otherwise, your participation will be considered permission for Iowa State University and the Department of Recreation Services to photograph, film, audio/video tape, record and/or televise your image and/or voice to use in any publications or promotional materials, in any medium now known or developed in the future without any restrictions. If you object to Recreation Services using your image or voice in this manner, please notify the Department of Recreation Services. 

  • Any individual(s) who seeks to film (photograph/video), interview, or conduct class projects in any Recreation Services facility must first receive permission from the Recreation Services Marketing team. Taking pictures or selfies via cameras, video cameras, and video-ready cell phones is strictly prohibited in our facilities (excluding Recreation Services programming).  

  • Photography and video of one member by another requires their consent. Photos and video compromise the privacy of Recreation Services members and will not be tolerated. Members are encouraged to report all violations of this policy to our front desk staff.  Disciplinary action may be taken. 

State Gym Sport Clubs Storage & Multipurpose Room Access  

Club Storage Cages (Rooms 0112 & 1130) 

Clubs that have storage cages/cabinets in State Gym room 0112 or 1130 need to follow this procedure to access those areas: 

  • Each club will have a combination code assigned to them from their club officer to unlock and access their individual cage. 

Multipurpose Room 1130 (Boxing Ring Area)  

Multipurpose Room 0112 

  • During scheduled club practices or group reservation go directly to your space. 
  • ONLY ISU eligible students and two coaches are allowed in this space.  Non eligible individuals need to purchase a membership or day pass.  Violation of this policy may result in club sanctions and affect the availability of this space. 
  • If others will not vacate your reserved space go to the front Service Desk and inform the Building Supervisor what the issue is and they will remove the group that does not have a reservation. 

Client Forms

Release of Information (Sign electronically)

Parental Consent for Treatment of a Minor (Sign electronically)

Fee Appeals Form (Sign electronically)

Policy Documents

Notice of Privacy Practices

Privacy Practices

Iowa State University Student Counseling Services (SCS) is a component of the Iowa State University Health Care Providers. As a Iowa State University Health Care Provider, we abide by the Privacy Practices outlined in the Notice of Privacy Practices for Iowa State University Health Care Providers. When you come for you initial appointment, you will be asked to acknowledge in writing that you have seen this notice. We recommend you review it carefully as it describes how medical information about you may be used and disclosed as well as how to access this information, In addition to the pdf version available on this page, we also maintain copies in our waiting and at the front desk.

Confidentiality Policy

As spelled out in our Privacy Practices, we adhere to the Health Insurance Portability and Accountability Act (HIPAA) to guard your protected health information. Further, we are also guided by our professional code of ethics, which state that all services of the Student Counseling Service are strictly confidential. Staff typically cannot release any information regarding clients, or the services they receive, to anyone outside of the Student Counseling Service without the written permission of the client. In those rare situations in which students indicate a high likelihood of harming themselves or others, staff may be legally required to release client information (with or without written consent) to protect the safety and will-being of the person(s) involved. Further, all counseling staff are considered “mandatory reporters” under Iowa law, meaning that in certain situations we are compelled to report suspected cases of child abuse, elder abuse, or dependant adult abuse to the proper authorities.