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.

Exemptions from required vaccinations

• Medical exemptions: Medical exemptions may be requested by completing the form available on the Yale Vaccine Portal. Documentation from a healthcare provider is required and will be reviewed by Student Health for appropriateness.
• Religious exemptions:  In accordance with CT state statute, Yale does not offer religious exemptions for required vaccinations except for flu and COVID (required for healthcare students only.) Under Public Act 21-6 passed by the Connecticut legislature, no new religious exemptions are allowed after April 27, 2021. The law outlines an exception for those with a valid religious exemption established by midnight April 27, 2021, for students enrolled at Yale on or before April 28, 2021. Religious exemptions from outside of Connecticut OR exemptions from K-12 schools will not transfer to Yale. Requests for religious exemption for COVID vaccination are available on the Yale Vaccine Portal.

Effective May 15, 2023, COVID-19 vaccination for incoming (matriculating) students in 2023 is strongly encouraged but not required. Students are required to submit documentation of prior any primary series vaccinations or bivalent boosters that they have received.

Required Forms due August 1

• Vaccination Record (download and print this form now, and take it to your provider to complete) submit to yale.medicatconnect.com
  • Instructions for Completing the Vaccination Record
• Health Form and Physical Exam submit to Yale Health

Other Forms

• Yale Health Hospital/Specialty coverage waiver submission (only for students who want to waive parts of the coverage – available in June, deadline September 15, 2023), the enrolled student’s netID and password are 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 ongoing 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)
• Opting out of CONNIE (Connecticut's Health Information Exchange)
• Yale Health Student Handbook
• Student Rates
• 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!

In order to receive care from Yale Health, your consent to treatment is required.  By presenting to the Yale Health Center for care, you implicitly consent to and/or acknowledge the following: (i) you consent to treatment as a patient of Yale Health for the purpose of receiving medical care and treatment and/or diagnostic procedures as determined to be necessary or advisable in your care; (ii) you consent to admission to the Yale Health Infirmary when indicated by your medical condition; (iii) you consent to the performance of one or more tests to determine your blood alcohol breath level if you present to Yale Health intoxicated, in connection with which you may be admitted to the Yale Health Infirmary or transferred to the Yale-New Haven Hospital emergency department; (iv) you acknowledge that Yale Health may use telehealth tools in your care including, but not limited to, video visits, e-consults with specialists, and audio and/or video monitoring in acute and inpatient departments; (v) you acknowledge that as part of your medical care and treatment, you may be tested for HIV and this testing is voluntary; you will notify your Yale Health care provider if you do not agree to HIV testing; and (vi) you acknowledge that photographic images, videotaped images or other images may be made of you for purposes of medical documentation or education as Yale Health deems appropriate, and that the use or release of such images will be in accordance with Yale Health’s Notice of Privacy Practices. You acknowledge that discussion of the risks, benefits, and alternatives to each procedure, treatment, or test is available to you so that you can make informed decisions about your care.