Forms

Medical Release & Return 

• Authorization for Release of Protected Health Information
• Medical Return Form
• Porter Medical Center Medical Records Release (Middlebury)
• University of Vermont Medical Center Medical Records Release (Burlington)

College-Sponsored Health Insurance Forms (Gallagher/Wellfleet)

• Prescription Override Form 
• Medical Claim Form 

Minor Treatment/Consent 

• Consent Form for Treatment of a Minor

Exemption Forms and Documentation

• Vermont Colleges Vaccine Exemption Form
• NCAA ADD/ADHD Medical Exception Documentation

Vermont State Forms for Advance Directives/Health Care Agents

• Vermont Department of Health: Create, Register, and Edit Advance Directive or Establish Health Care Agent