Health Services

Please print, complete, and mail paper copies of these required forms.

Deadline

You will not be permitted to register for classes until forms are submitted and immunization requirements are met.

Required Forms

• Acknowledgement of Receipt
• Health Form and Physical Exam
• Vaccination Record for Incoming Students
• Student Allergy Medical Treatment Plan – for students who have begun allergy immunotherapy and want to continue to receive allergy injections while on campus

Read and Review

• Notice of Privacy Practices (NOPP)
• Quick Guide to Yale University Health Services - an overview of Yale Health Plan (YHP) coverage
• YHP Student Handbook for detailed plan information and to decide whether to keep Yale Health Plan Hospitalization /Specialty Care Coverage or waive the coverage. If you choose to waive hospitalization coverage, proof of alternate hospitalization coverage is required. Students enrolled at least half-time in a Yale degree program are automatically enrolled and charged a premium for YHP Hospitalization/Specialty Care and YHP PrescriptionPlus. Students will be contacted via email with instructions for submitting an insurance waiver online in June.
• Additional Optional Forms

Contact Yale Health Plan Member Services if you have any questions or to discuss your options for health coverage: member.services [at] yale.edu or (203) 432-0246.