Health Forms for Students
For questions about any of these forms, please call our office at 585-245-5736 (Health Services) or 585-245-5716 (Counseling Services).
Student Health and Counseling Department
- Authorization for Release of Information
Must be completed in-person OR submitted signed, witness, and with a copy of ID (e.g., Driver's License) - Wegmans Prescription Delivery
Health Services
- Consent for Medical Treatment of a Minor
- Instructions for Electronic Consent for Medical Treatment of a Minor
- Immunization Record
- Meningococcal Waiver (sign into MyHealth and go to Medical Clearances)
- MMR Medical Exemption Form
- MMR Religious Exemption Form
- Physical Evaluation
- Tuberculosis
- Health Care Proxy/Advance Directives