General MIT Health Forms and Documents
Health history forms
Medical record forms
- Authorization for Release of Protected Health Information (Medical Record) to MIT Health
- Authorization for Release of Protected Health Information
(Medical Record) by MIT Health - Authorization for Release of Protected Health Information
(Dental Record) by MIT Health - Authorization for Release of Protected Health Information – Dental Record
- Request for Amendment of Protected Health Information
Patient privacy / advocacy / rights
Student health forms
- Student Medical Forms Information
- Varsity Student Athlete Physical Examination Form
- Student Vaccine Exemption Form
- Student Tuberculin Requirement Form
- Information about Meningococcal Disease, Meningococcal Vaccines, Vaccination Requirements and the Waiver for Students at Colleges and Residential Schools