Forms

College-Sponsored Health Insurance Forms (Gallagher)

• Prescription Override Form 
• Medical Claim Form 

Exemption Forms and Documentation

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

Medical Release & Return 

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

Minor Treatment/Consent 

• Consent Form for Treatment of a Minor

COVID Forms

• COVID Testing Consent - Student
• COVID Testing Consent - Employee
• COVID Vaccine Exemption Form

Other College Forms

• Advance Directive/Assigning a Healthcare Agent