{"id":2084,"date":"2020-07-07T10:01:27","date_gmt":"2020-07-07T14:01:27","guid":{"rendered":"https:\/\/web.uri.edu\/health-draft\/?page_id=2084"},"modified":"2026-02-25T11:24:55","modified_gmt":"2026-02-25T16:24:55","slug":"forms","status":"publish","type":"page","link":"https:\/\/web.uri.edu\/healthservices\/forms\/","title":{"rendered":"Forms"},"content":{"rendered":"\n<ul class=\"wp-block-list\">\n<li><a rel=\"noreferrer noopener\" href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/Authorization-2023-Fill-in-1.pdf\" target=\"_blank\">Authorization to Release or Request Medical Records<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/2025-2026-Enrollment-Form-FIll-in.pdf\">2025 &#8211; 2026 Health Insurance Enrollment Form<\/a><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/2023-2024-Enrollment-Form-4.19.23-Fill-in.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"> <\/a>(to be used to enroll part-time students and dependents)<\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/wp-content\/uploads\/sites\/1769\/Spirometry-Instructions-2020.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Instructions for Patients Undergoing Spirometry<\/a> (Asthma Testing)<\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/Spring-2026-Insurance-Petition_fillable.pdf\">Spring 2026 Late Insurance Fee Petition Form<\/a> (only to be completed if you were charged $2,343 on your Spring 2026 tuition bill)<\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/Fall-2025-Insurance-Petition-fillable.pdf\">Fall 2025 Late Insurance Fee Petition Form<\/a> (only to be completed if you were charged $3,512 on your Fall 2025 tuition bill)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">New Student&nbsp;Forms<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/Student-Emerg-Contact-Form-Fall-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Student and Emergency Contact Form<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/Physical-Exam-Fall-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Physical Exam Form<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/Immunization-Record-Fall-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Immunization Record<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/TB-Screening-Form-Fall-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">TB Screening Form<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/TB-Risk-Assessment-Fall-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">TB Risk Assessment Form<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/TYH_online-2024-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">To Your Health Booklet<\/a><\/li>\n<\/ul>\n\n\n<section class=\"cl-wrapper cl-boxout-wrapper\"><div class=\"cl-boxout  \"><h1>Privacy Notice<\/h1>\n\n<p>URI Health Services&#8217; <a href=\"https:\/\/web.uri.edu\/healthservices\/wp-content\/uploads\/sites\/1769\/HIPAA-NPP-URI-NPP-v5-010318_FINAL.pdf\">Notice of Privacy Practices <\/a>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).<\/p>\n\n<\/div><\/section>\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>New Student&nbsp;Forms<\/p>\n","protected":false},"author":581,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-2084","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/web.uri.edu\/healthservices\/wp-json\/wp\/v2\/pages\/2084","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/web.uri.edu\/healthservices\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/web.uri.edu\/healthservices\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/web.uri.edu\/healthservices\/wp-json\/wp\/v2\/users\/581"}],"replies":[{"embeddable":true,"href":"https:\/\/web.uri.edu\/healthservices\/wp-json\/wp\/v2\/comments?post=2084"}],"version-history":[{"count":4,"href":"https:\/\/web.uri.edu\/healthservices\/wp-json\/wp\/v2\/pages\/2084\/revisions"}],"predecessor-version":[{"id":10592,"href":"https:\/\/web.uri.edu\/healthservices\/wp-json\/wp\/v2\/pages\/2084\/revisions\/10592"}],"wp:attachment":[{"href":"https:\/\/web.uri.edu\/healthservices\/wp-json\/wp\/v2\/media?parent=2084"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}