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Forms

Center for Health and Wellness Forms

Immunization Consent Form (for students under 18 who wish to receive a vaccine at a campus-sponsored clinic)
Immunization Exemption Form (for medical or religious reasons)
Immunization Record
Medical Release Form (to release information to and from Bentley)
Meningitis Waiver Form
Nutrition Consultation Form (to be completed prior to your appointment with the nutritionist)
Physical Exam Form
Tuberculosis Risk Questionnaire and Evaluation
Women’s Health Form

Counseling Center Forms

Client Informed Consent Form
General Intake Form