• Authorization to Release or Request Medical Records
• 2023-2024 Health Insurance Enrollment Form (to be used to enroll part-time students and dependents)
• Instructions for Patients Undergoing Spirometry (Asthma Testing)
• Fall 2023 Late Insurance Fee Petition Form (only to be completed if you were charged $3,135 on your Fall 2023 tuition bill)
• Spring 2023 Late Insurance Fee Petition Form (only to be completed if you were charged $2,092 on your Spring 2023 tuition bill)

New Student Forms

• Student and Emergency Contact Form
• Physical Exam Form
• Immunization Record
• TB Screening Form
• TB Risk Assessment Form
• Consent for Treatment of a Minor
• To Your Health Booklet
• Online Health Behavior Survey

Privacy Notice

URI Health Services’ Notice of Privacy Practices describes how medical information about you may be used and disclosed, and how you can get access to this information. The form is made necessary by the federal Health Insurance Portability and Accountable Act (HIPAA).