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Health and Immunization Records are due once for incoming undergraduate and graduate students.

Insurance Selection and Reporting forms are due annually upon enrollment. They are due June 22 for students entering during the fall semester and Dec 1 for midyear students entering in January.

Forms

Health and Immunization records are due once upon enrollment.

Insurance Reporting and Selection forms must be reported annually.

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UNDERGRADUATE FORMS

Undergraduate Health and Immunization Records
This form includes the required health history, immunization documentation, the Tuberculosis (TB) risk assessment, and the medical health physical form needed for entering undergraduate students. It is due before your arrival on campus.

Undergraduate 2014 Summer Insurance Selection and Reporting Form This form is required annually for newly enrolling students attending school 3/4 and full time during the summer of 2014.

Release of Medical Information Form Complete this form to request information from your Brandeis medical record or to have your health records sent the Brandeis Health Center.  Please note we need at least three business days to process these requests.

Meningococcal Waiver Form This form is also found in the incoming student health report packages.

Non Reportable Health Insurance Review/Appeal Form Complete this form to have your insurance reviewed if you believe you're insurance meets regulatory requirements and is comparable to the QSHIP but you are being told that your insurance is non reportable.

GRADUATE FORMS

Graduate Health and Immunization Record This form includes the required health history, immunization documentation, and the tuberculosis (TB) risk assessment forms needed for entering graduate students. It is due before your arrival on campus.

Graduate 2014 Summer Insurance and Reporting Form This form is required for all newly enrolled students attending school 3/4 and full time during the summer term.

Release of Medical Information Form Complete this form to request information from your Brandeis medical record or to have your health records sent the Brandeis Health Center.  Please note we need up to  three business days to process these requests.

Meningococcal Waiver Form This form is also found in the incoming student health report packages.

Non Reportable Health Insurance Review/Appeal Form Complete this form to have your insurance reviewed if you believe you're insurance meets regulatory requirements and is comparable to the QSHIP but you are being told that your insurance is non reportable.

RELEASE OF MEDICAL INFORMATION FORM
Release of Medical Information Form Complete this form to request information from you Brandeis medical record or to have your health records sent to Brandeis Health Center. Please not we may need up to 3 business days to process requests.