Policies & Forms

Policies and Procedures

Cancellation, Late Arrival, and Missed Appointment Policy
Immunization Compliance Policy
Patient Rights and Responsibilites
Medical Excuse Notes
External Lab Policy
Medication Injection and Biologics Procedure

Forms

Authorization to Treat a Minor
New Undergraduate Student Health Forms
New Graduate Student Health Forms
New Transfer Student Health Forms
Release of Medical Information
Vaccine Exemption Form
Stimulant Refill Policy

For students wishing to refill their stimulant medications with a WPI SHS provider, please carefully read the document below and ensure all documentation is received by our office before scheduling your first medication refill appointment with us. 

Request for Medication Storage

This form allows students to request storage of their prescribed medication at WPI Student Health Services (SHS) as a courtesy. Students must provide details about the medication and its storage requirements. Students who need to store prescription medication at WPI Student Health Services (SHS) must complete and submit this form before any medication can be accepted or stored.

Medication and Biologic Injections at WPI SHS

Students who receive biologic injections prescribed by an outside healthcare provider and would like WPI Student Health Services (SHS) to administer these injections must complete this consent form before receiving injections at SHS. A current provider order is required, injections are provided by appointment only, and students must follow all SHS policies regarding medication management, scheduling, and post-injection observation.

Additional requirements include:

  • Students must have previously tolerated at least two doses administered by their prescribing provider (or have continued home administration without interruption) before receiving injections at SHS.
  • Students are responsible for coordinating medication delivery and proper storage of their biologic medication.
Use of Treatment Room at WPI SHS

Students should complete this form if they need to use a private treatment room at WPI Student Health Services (SHS) for a medical treatment that will be performed by their own outside healthcare provider or for a treatment they administer themselves, such as an infusion, injection, or other approved medical treatment. This form documents the treatment schedule, provider information (if applicable), and acknowledges that SHS is providing the space as a courtesy and is not responsible for providing or administering the treatment. Use of the treatment room is available only during approved dates and times when SHS is open and requires adherence to all SHS policies and procedures.