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Health Records are due once for incoming undergraduate and graduate students.
Insurance Selection and Reporting forms are due annually. They are due June 30 for students attending the fall semesters and Dec 1 for midyear students entering in January.
Forms
Massachusetts public health regulations require us to document, review, and update as needed the health and immunization status of our incoming students. These forms are due before your arrival on campus.
Insurance reporting and selection forms must be filled out each year by June 30 for students attending in the Fall semester and by Dec 1 for midyear students entering in January.
Undergraduate Health and Immunization Forms
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.
Graduate Health and Immunization Forms 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.
Undergraduate Insurance Selection and Reporting Form This form is required annually to ensure that students attending schools in MA have insurance which meets MA Student Health Insurance regulations.
Graduate Insurance Selection and Reporting Form This form is required annually to ensure that students at MA schools have insurance coverage which meets MA Student Health Insurance Regulations.
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.