Policies & Forms
Student Health Services has compiled a list of relevant forms that students may need to fill out during their time at WPI.
- Policy Regarding Prescribing Medicine for ADD/ADHD
- Medical Excuse Policy and Verification of Visit Letters
- Immunization Compliance
- Health Insurance Portability and Accountability Act - HIPAA
- Patient Rights and Responsibilities
- Authorization for Disclosure
- Please use this form when requesting medical records be released to or from WPI Student Health Services
- Consent to Treat Minor Form
- Tuberculosis Risk Questionnaire
- Meningitis Vaccine Waiver
- Immunization Records and Requirements
- Physical Exam Document
- Required Student Health Forms
- A complete list and descriptions of required health forms and immunizations for incoming students.
WPI provides a process for students to submit a request for a medical or religious exemption for all required vaccinations. Students must complete a Vaccine Exemption Form and specify whether they are asking for a medical or religious exemption. If a student requests a medical exemption, they must upload a Medical Provider Exemption Letter from their healthcare provider in addition to the Vaccine Exemption Form. See the instructions below.
To access and upload the exemption form, please complete the following steps:
- Download, print, complete, and sign the Student Vaccination Exemption Form.
- To upload the completed form, log into the WPI Student Health Portal
- Select the upload tab; scroll down to see the drop-down list of documents available for upload.
- Select "Student Vaccine Exemption Form" and upload the completed exemption form.
- Select "Medical Provider Exemption Letter" from the drop-down list, select file, and upload the exemption letter if required.