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 your immunization requirements are met. Some immunization requirements may take a month or more to complete.
Required Forms due August 1, 2021
- Vaccination Record (download and print this form now, take to your provider) submit to yale.medicatconnect.com after June 20
- Vaccination Record Instructions for Graduate and Professional Students
- Health Form and Physical Exam submit to Yale Health (due to the COVID-19 pandemic if you cannot obtain a physical exam please provide a copy of your most recent one if it is from the last 1-2 years)
Other Forms
- Waiver submission (only for students who want to waive parts of the coverage – available in June, deadline September 15, 2021)
- Student Allergy Medical Treatment Plan (only for students requiring on-going treatment by an allergist)
- Student Enrollment/Change Application (for dependents and Affiliate plan)
Information for Review
- Notice of Privacy Practices (NOPP)
- Yale Health Student Handbook
- Student Rates (2020-2021 rates, next year’s rates will be available later this spring)
We’re working together to get you off to a healthy start at Yale!