UMass Boston

General Medicine Forms

Required Forms

Please upload these forms to the My Health Beacon Portal or fax to 617-287-3977. 

• Consent to Treat Minor Patients
• Immunization Form

Release Forms

If you would like to request your immunization records, and/or clinical records, please fill out this form and fax it to 617-287-3977, drop it off at UHS, or email it to uhs@umb.edu.

• Release of Medical Information Form

Exemption Forms

• Medical Immunization Exemption Form

Additional Forms

• COVID-19 Vaccine Minor Consent Form
• Sports Physical Pre-Participation Health History Form
• Travelwell Health History Form
• Tuberculosis (TB) Clearance Form