New Graduate and Professional Student Forms

Welcome to Yale Health! Please review the documents below for information about your health services requirements and deadlines for submission.

You will not be permitted to enroll in classes until all the forms are submitted and the immunization requirements are met.

Instructions

• FAQs for Student Vaccination Record Form
• Information for Your Doctor
• New Student Info Sheet

Required Forms

• Vaccination Record for Incoming Students (due June 21, 2013)
• Health Form and Physical Exam (due June 21, 2013)
• Acknowledgement of Receipt of NOPP (due June 21, 2013)

Other Forms

• Waiver submission (only for students who want to waive parts of the coverage – available in June, deadline September 15, 2013)
• Student Allergy Medical Treatment Plan (only for students requiring on-going treatment by an allergist - due July 19, 2013)
• Student Enrollment/Change Application (for dependents and Affiliate plan)

Information for Review

• Notice of Privacy Practices (NOPP)
• Student Guide to Yale Health
• Yale Health Student Handbook
• Student Rates
  

Contact our Member Services Department at member.services@yale.edu or 203-432-0246 if you have any questions or to discuss your options for health coverage.

We’re working together to get you off to a healthy start at Yale!