This page contains many of the documents and forms required to release information, request immunization records, return from medical leave of absence, and so forth.
- An authorization to release medical or mental health records.
- Order Form to request refills of birth control pills.
Minor Consent to Treatment Form
- An authorization from parent or legal guardian allowing SHAC to treat students under 18 years of age.
Immunization Record Request Form
- To request immunization records be released to a 3rd party or to the student after graduation. Student health records are retained for 8 years after graduation.
Conscientious or Religious Exemption Form
- For use if unable to meet required immunizations due to conscientious or religious belief.
Mental Health – Medical Leave of Absence Return Questions
- A form used for an off-campus mental health provider (therapist, psychiatrist) to relay mental health information regarding a student’s ability to return to Carleton from a Medical Leave of Absence.
Physical Health-Medical Leave of Absence Return Questions
- A form used for an off-campus physician to relay physical health information regarding a student’s ability to return to Carleton from a Medical Leave of Absence.
- Informed Consent to Treatment and Privacy Practices
- Informed Consent to Telehealth Services
- Information for students with ADHD
- Communication Policy
- Excuse Note Policy
- Physicals Policy
SHAC does not store personal medications for students. We suggest purchasing a refrigerator or lock box to use in your dorm room.