Health Records and Other Forms

This form is to request copies of your medical records which are kept at Brandeis Health Center for 10 years.

For Incoming Students

All incoming students are required to complete a health report once upon matriculation.

Students will need to have their health care provider complete and sign the required health records.

To be completed by a Medical Provider only with identified positive screening risks.

A Physical done within six months is required for NCAA athletes (and is submitted to Athletics separately on your own) and is recommended for Health Services.

Accessibility and Accommodation Forms

The Health Center does not directly provide accessibility accommodations for students but provides, as needed, a medical review and support for clarifying medically required accessibility and accommodation needs.

Housing Accommodation Application (PDF)
The process for requesting and acquiring housing accommodations is managed by the Department of Community Living (DCL) with support from the Brandeis Housing Accommodation Review Committee. The DCL Accommodations page provides information on the process for requesting accommodations, as well as important timelines. Please visit their Webpage for additional details.
Parking and Dietary Accommodations

The process for Parking and Dietary Accommodation requests is managed through  Student Accessibility and Supports  with the Parking and Dietary Review Committees. Please see their site for more information on these processes. 

Waiver Forms

This form is for students living on campus to provide informed declination of required Meningococcal vaccine (this is not recommended).