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Health Forms to Download

Health History and Physical Exam [pdf] All students are required to complete the Health History form. If you are an intercollegiate athlete please complete Athletic Health History and Physical Exam form instead.

Athletic Health History and Physical Exam [pdf] All intercollegiate athletes are required to complete this form and submit it to the Health Center no sooner than six months prior to the first day of tryouts/practice. You cannot be cleared for an intercollegiate team sport without completing this form.

Release of Health Records [pdf] [doc] A release of health records must be completed to release any part of your medical record.

Mandatory Meningitis Response Form [pdf] [docMust be completed and returned to the Health Center before the start of classes.

Meningococcal Meningitis Fact Sheet [pdf]

For more information, please feel free to contact the College Health Center and/or consult your physician. You can also find information about the disease at the New York State Department of Health Website: http://www.health.ny.gov/ or American College Health website

Dental Hygiene Hepatitis B Waiver Form – Dental Hygiene AAS curriculum [pdf] [doc

Parental Consent Form [pdf] [doc For parents or guardians of students under eighteen years of age. In order to procure medical care for your student and to avoid unnecessary delay, you are encouraged to sign the consent for medical treatment and return the form to the Davis Health Center. Be assured that we make every effort to notify parents as soon as possible, in case of major injuries or serious illnesses.

International Summer Programs - Required forms for participants in our International Summer Programs. Go to our International Summer Program web page.

Notice to Victims of Sexual Assault [pdf]