Center for Health & Wellness
Health Forms
All forms except the Online Health Insurance Waiver are in PDF format.
Required Forms for All Incoming Students
- Health Center Entrance Letter
- Health Center Entrance Checklist
- Health Center Entrance Form - Required for All Incoming Students*
- Meningitis Information and Vaccination Waiver - Required for all Undergraduate Students**
Frequently Used Forms
- Authorization for Release of Medical Records
- Authorization for Release of Drug/Alcohol Information
- Religious Exemption for Immunizations
- Student Health Insurance Plan Online Waiver Form
Meningitis Information
*Denotes required forms for all students
**Denotes required forms for undergraduate students
contact us
Location: 216 Tremont Street, Third Floor, Room 303
Mailing Address:
Center for Health and Wellness
120 Boylston Street
Boston, MA 02116
Phone: 617-824-8666
Fax: 617-824-7897
Email: healthservices@emerson.edu
(non-emergencies only)
hours of operation
During the school year:
Monday: 9 am–12 pm, 1–5 pm
Tuesday: 9 am–12 pm, 1–8 pm
Wednesday: 1–8 pm
Thursday & Friday: 9 am–
12 pm, 1–5 pm
Saturday & Sunday: CLOSED
Sexual Assault
local medical resources
Browse our list of local clinics to call when the CHW is closed.
