New Undergraduate 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.
- Vaccination Record (due January 2, 2017 for students entering for the spring semester)
- Health Form and Physical Exam (due July 1, 2016)
- Waiver submission (only for students who want to waive parts of the coverage – available in June, deadline September 15, 2016)
- Authorization for Medical Care and Treatment (only for students under the age of 18)
- Student Allergy Medical Treatment Plan (only for students requiring on-going treatment by an allergist)
- Varsity Athlete Required Forms (only for intercollegiate athletes – due July 1, 2016)
- Student Enrollment/Change Application (for dependents and Affiliate plan)
- Designation of a Personal Representative to Access Health Information
Information for Review
- Notice of Privacy Practices (NOPP)
- Yale Health Student Handbook
- Student Rates
- NCAA ADHD Medical Exception Reporting Form
- NCAA Sickle Cell Trait Guideline (see page 92)
Contact our Immunizations Department at email@example.com if you have any questions regarding your pre-entrance requirements.
We’re working together to get you off to a healthy start at Yale!