Forms and documents used at Boynton Health.
Medical Records and Billing Forms
- Health information release form
- Billing information release form
- Immigration health information release request form
- Immunization requirements forms and procedures
- Blood borne pathogen exposure procedure and form
Patient Forms
Dental
*These forms are fillable when downloaded to your desktop.
- Dental Communication Consent
- Dental COVID-19 Risk Consent
- Dental Medical History
- Dental Patient Responsibility Statement
Medical
- ADHD Stimulant Agreement Form
- PrEP Agreement Form
- Cologuard Order Requisition Form
- AHS Immunization Form
Mental Health
- ADHD Stimulant Agreement Form
- Academic Medical/Disability Supplement Form
- Student Services Fee Assessment Request Form
- ISSS Health Information Release Form
- DRC Health Information Release Form
Absence Notes
Under the University of Minnesota's Make-up Work for Legitimate Absence Policy, Boynton Health does not provide absence notes. The policy explains what you need to do if you miss class or coursework. Learn more about the absence note policy.