Forms

COVID Forms

• COVID Testing Consent - Student
• COVID Testing Consent - Employee
• COVID Testing Name Card
• COVID Testing Fact Sheet
• COVID Vaccine Exemption Form

College Insurance Forms (Gallagher)

• Prescription Override Form (student health insurance)
• Medical Claim Form (student insurance only)

Medical Exemption Forms & Documentation

• Middlebury College Influenza Vaccine Exemption Form
• NCAA ADD/ADHD Medical Exception Documentation

Medical Release & Return Form

• Authorization for Release of Protected Health Information
• Medical Return Form

Minor Treatment/Consent Forms

• Treatment of a Minor
• Consent Form for Treatment of a Minor

Other College Forms

• Advance Directive/Assigning a Healthcare Agent
• Information about Confidentiality and Your Health Record at Parton