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. Some immunization requirements may take a month or more to complete.
Instructions
Required Forms
- Vaccination Record (download and print this form now, take to your provider) submit to yale.medicatconnect.com after June 20
- Health Form and Physical Exam (due August 1, 2019) submit to Yale Health
Other Forms
- Waiver submission (only for students who want to waive parts of the coverage – available in June, deadline September 15, 2019), the enrolled student’s netID and password is required to log into the submission site
- Varsity Athlete Required Forms
- 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)
- Student Enrollment/Change Application (for dependents and Affiliate plan)
- Designation of Patient Spokesperson
Information for Review
- Notice of Privacy Practices (NOPP)
- Yale Health Student Handbook
- Student Rates 2018-2019 (2019-2020 rates will be available later this spring)
- Caring for the Varsity Athlete
- NCAA ADHD Medical Exception Reporting Form
- NCAA Sickle Cell Trait Guideline (see page 92)
We’re working together to get you off to a healthy start at Yale!