New student health requirements

Students will access most of their health requirements forms through their Medical Clearance list in myCornellHealth. Links to additional forms you may need are provided here.

General forms

NCAA Student Athletes only

Using your legal name vs. chosen name on forms

If you use a chosen name that is different from your legal name, you may use either name on Cornell Health forms. Learn how to update your chosen name in myCornellHealth by visiting our Especially for LGBTQ+ Students page or our Especially for International Students page. 

INSTRUCTIONS: Download or print the applicable form, and then complete all information. If you are not completing electronically, please use blue or black ink. Submit the form according to directions indicated on the form.

Release of health records; notice of privacy practices

Protected Health Information (PHI) patient rights forms

The Health Insurance Portability and Accountability Act (“HIPAA”) gives you the right to make the following requests regarding your Protected Health Information (PHI):

Health forms

Department charge authorization