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Medical Services

Medical Forms

Send the completed forms to:

Smith College Health Services
69 Paradise Road
Northampton, MA 01063

Fax: 413-585-4639

Health Services Entrance Form

Required for first-year students

A completed Health Services entrance form (medical history and physical examination) and an up-to-date immunization record are required to use Health Services. Students who do not provide these documents will be unable to pre-register for classes.

Medical Records Release Form

This release form is required to allow the transfer of medical information from Smith College Health Services to a secondary provider, such as your primary care provider at home or a referred provider.

Medical Release Form (PDF)

Requests are done in the order in which they are received and may take up to two weeks to complete