All the health forms!

Last updated December 2, 2024

Find commonly used forms all in one place. Please follow the instructions to complete each form. These forms are in fillable PDF format that allows you to download, complete and save to your computer/device. You can then email it to us.

Additional details can be found in the ASSOCIATED SERVICES section of this page.

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).

New Patient Registration Package

• 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.

Forms for Students/Patients

When you book the appointment, the staff may advise you to complete a form or forms for the appointment. Please fill out the appropriate form before your appointment. Email the completed form(s) to us at admin.hwc@utoronto.ca.

• Allergy Immunotherapy Intake Form (PDF): (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.
• General Assessment Form (PDF): to complete before your general assessment.
• Periodic Health Visit Form (PDF): to complete before your periodic health check-up.

Forms to Request Patient Health Records

• Medical Release Form to Health & Wellness (PDF): to authorize the Health & Wellness Centre to obtain your health records from other healthcare professionals.
• Medical Release Form from Health & Wellness (PDF): to authorize the release of your health record from Health & Wellness; to obtain a copy of your health record; Follow the instructions on the form and email the completed request form to us at medicalrecords.hwc@utoronto.ca.

Referral Forms for Healthcare Providers

• Psychiatry Referral Form (PDF): (for a physician) to refer a currently registered U of T student to Health & Wellness for brief episodic psychiatric care. Note: If you are a physician at the UTSC Health & Wellness Centre and UTM Health & Counselling Centre, please use UTM/UTSC to UTSG Psychiatry Referral form, not this form.

Other Forms

• Verification of Illness Form (PDF): The Verification of Illness (VOI) or Injury form (also known as a “doctor’s note”) may be required for a missed academic obligation in some circumstances. It is the official University of Toronto form for all students who are requesting academic consideration based on illness or injury.