Forms

Please complete these forms prior to your appointment to save you time!

Other forms may need to be completed by your health care provider (either at the Health Service or in the community):

Authorization For Release of Medical Information

This form will permit Health Services to release necessary medical information to a specific recipient.

Complete the form and submit by either:

(1) email: healthask@mail.studentlife.utoronto.ca

(2) fax: 416-971-2089

(3) drop off at Accounts Office in Health Services

 

Please note the fee must be paid before the request is processed:

  • $30 for up to 20 pages and $0.25 per page thereafter
  • $5.00 charge for postage and handling (additional postage charges may apply for US and International mailing)
  • Xpresspost (with a tracking number) is available for an addition $15.00

 

Problems & Troubleshooting

If you are unable to view or print our forms, please visit or send someone on your behalf to our clinic to pick up a hardcopy.
 

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