Last updated May 23, 2024
We have collected all the forms in one place for you to ensure your visit to Health and Wellness is time well spent. Please fill out the appropriate form before your appointment. Additional details can be found in the ASSOCIATED SERVICES section of this page.
New! Fill out and sign forms digitally, then email the completed form(s) to us at admin.hwc@utoronto.ca. Your signature is required in order for you to receive care from Health & Wellness.
The form(s) on this page are fillable PDFs. Download the file, complete the form and save it to your computer before emailing it to Health & Wellness. Having trouble? Watch this YouTube tutorial if you’re using Adobe Acrobat Reader, or this YouTube tutorial if you’re using a Mac (no additional software necessary).
Bring your T-Card, Ontario Health Card (OHIP), other Canadian Provincial Health Card, or a printout of University Health Insurance Plan (UHIP) to every appointment.
- Registration Package (formerly New Client Form): Please call 416-978-8030 (Monday – Friday, 9 a.m. – 4:30 p.m.) to register as a new patient before your first appointment. Our reception staff will email the Registration Package through a secure online portal.
- Registration Package for International Students (formerly New Client Form for International Students): Please call 416-978-8030 (Monday – Friday, 9 a.m.– 4:30 p.m.) to register as a new patient before your first appointment. Our reception staff will email the Registration Package for International Students through a secure online portal.
- Client Record Form: to complete before your first Mental Health Screen / Assessment.
- General Assessment Form: to complete before your general assessment.
- IUD Insertion Form: to complete before an IUD (Intrauterine Device) insertion.
- Allergy Immunotherapy Intake Form: (for a student to bring to an allergist for completion) to provide clarity about allergy regimen and protocol for a currently registered U of T student receiving allergy care at Health & Wellness.
- Psychiatry Referral Form: (for a physician) to refer a currently registered U of T student to Health & Wellness for brief episodic psychiatric care.
- Same-Day Counselling Form: to complete before your same-day counselling appointment. Email the completed form to mentalhealth.hwc@utoronto.ca.
- Counselling Form: to complete before your same-day counselling appointment IF you have had a same-day counselling session before. This is a shorter form. Email the completed form to mentalhealth.hwc@utoronto.ca.
- Periodic Health Visit Form: to complete before your periodic health check-up.
- Pre-Travel Information Form: to complete before your travel clinic appointment.
- Medical Release Form to Health & Wellness: to authorize the Health & Wellness Centre to obtain your health records from other healthcare professionals.
- Medical Release Form from Health & Wellness: to authorize the release of your health record from Health & Wellness.
- Verification of Illness Form: if you need a healthcare professional to verify that you have been ill or injured.
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Associated Services
Periodic health visit
A health check-up, more formally known as Periodic Health Visit (PHV), replaces the annual physical examination. Learn more about Periodic health visitElectronic medical records and appointment booking system
Health & Wellness provides an electronic medical records (EMR) system for both U of T students and health-care professionals to to book and confirm appointments, deliver confidential information including lab results and more. Learn more about Electronic medical records and appointment booking systemDisability documentation
If you do not have a family physician or a care provider and you require disability documentation for academic accommodations, we may be able to help. Learn more about Disability documentationMental health clinical services
If you're looking for mental health services, Health & Wellness offers a variety of options to suit your needs. Learn more about Mental health clinical servicesSexual and reproductive health counselling and education
The physicians and nurses at the Health & Wellness Centre can provide counselling and information on the various forms of birth control, and can help you choose the method that is right for you. Learn more about Sexual and reproductive health counselling and educationImmunization services
We offer free vaccinations for diphtheria, polio, tetanus, mumps, measles and rubella. Other immunizations are available for a fee. Learn more about Immunization services