UMass Boston

General Medicine Forms

Required Forms

Please upload these forms to the My Health Beacon Portal or fax them to 617-287-3977. 

• Consent to Treat Minor Patients
• Immunization Form 2024-2025

Release Forms

To request your immunization records or clinical records, please follow these instructions.

• Release of Medical Information Form

Exemption Forms

• Medical Immunization Exemption Form

Additional Forms

• COVID-19 Vaccine Minor Consent Form
• Sports Physical Pre-Participation Health History Form
• Travelwell Health History Form
• Tuberculosis (TB) Clearance Form