Health History & Immunization Form

This form is for all entering Suffolk University Students. This is for all students who will be making their first visit to Health Services, and any student who has had a significant change in their health status since the last time they filled out this form. Please download and fill out this form before your scheduled appointment and bring it with you.
For new students, this form must be submitted to Health Services no later than August 1st, 2008.

Female History Form

This is for all women coming in for gynecological check-ups/ annual GYN appointments/ pap smears.  Please download and fill out this form before your scheduled appointment and bring it with you.

Authorization for Release of Information Form

All student medical information is kept confidential. The student’s permission must be obtained before Health Services will give information to anyone not directly related to their care. This includes parents and University officials.  If students would like to have their information released to another party, they must sign this form.

Meningitis Waiver Form 

**Note:  Only those students living within the Residence Halls on campus (Miller Hall, 10 West or 150 Tremont)  are required to have the meningitis vaccine.

Suffolk University Student Health Insurance Waiver Form

**Note:  The deadline to waive the health insurance is September 15, 2008  for the 2008-2009 school year.  If you do not waive by this date, you will incur the cost of the policy for the year.

** Please make sure to print out the confirmation page after you waive the insurance as this is the only documentation you will have that proves you waived.

Because of Massachusetts law, all entering Suffolk University students are automatically enrolled in the Suffolk University Student Health Insurance Plan.  All students must annually submit a waiver form if they will be using health insurance provided by an alternate U.S. based carrier.
Foreign insurance policies are not accepted and international students may not waive participation in the Suffolk University Student Health Insurance Plan.

More information about the Suffolk University Student Health Insurance Plan (SSHIP) can be found by clicking here.

Suffolk University Student Health Insurance Enrollment Form

If you do not have health insurance provided by a U.S. based carrier, you are required to participate in the Student Health Insurance Program offered through Suffolk University. This mandate includes all undergraduate and graduate students who are registered for 9 or more credits each semester and all international students (regardless of credits) including those sponsored by their embassy. The fee for the student health insurance offered through Suffolk University is $1,490 for full year coverage and $913 for Spring Semester Only.

More information about the Suffolk University Student Health Insurance plan can be found by clicking here.

Student Health 101 Newsletter - Parent Signup

Health Services offers free subscriptions to the Student Health 101 Newsletter as a service to both students and parents.  Each monthly issue of the newsletter is designed to help students understand the consequences of the decisions that they make while in college, covering topics including: Healthy Eating, Physical Fitness, Sexual Responsibility, Adjustment to College Life, Alcohol and Other Drugs, etc.

As a Suffolk parent, you’re invited to read the Newsletter along with your child.  Each issue will help you understand the important decisions that your child will face while in college.  You will also receive a Parent issue that will give you information on talking points.

Please click on the link above to confirm your no-cost subscription to Student Health 101