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Required Student Health Forms

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Student Health Services is committed to maintaining a safe and healthy campus. Here you will find the required student health forms to ensure compliancy with New York State Public Health Laws 2165 and 2167. These laws apply to all students.

Niagara University strictly enforces compliance with these laws. Students who do not submit the required information within thirty days of their first class will have their registration withdrawn. Withdrawn students cannot attend class, reside in college housing, access college technology, participate in or attend campus events. All requirements are due 30 days prior to the start of your classes.

Print and Submit Medical Forms

In person drop off: Located on campus in the Butler Building, if before or after hours a secure locked box is outside of the front door for paperwork drop off.

Fax: 716.286.8391

Student Health Center
P.O.Box 1923 Butler Building
Niagara University, NY 14109

**Due to HIPAA regulations, we are unable to accept any health forms by email**

Required Medical Forms (Print and Submit)

Please submit a copy of the front and back of your current Health Insurance or Health Card along with your required medical forms.  This copy is for Health Services records only, you will still need to follow the instructions on the Student Health Insurance page to waive/enroll in the insurance when it becomes available in July.

Additional Forms

Students who are under 18 years of age at the beginning of the Fall semester must fill out the Consent for Treatment of a Minor form to be seen and treated at Student Health Services.

Authorization from a medical provider disclosing health information, if necessary.