The deadline for submission is July 1, 2022 for first year, transfer and RUE students (January 3rd, 2023 for mid year transfers).
Please review and complete the required information listed. All forms can be accessed through the links below. For continuity of care, we request that students forward their medical records for any chronic, ongoing or serious medical condition.
If you haven't done so already, activate your Brown account. You will need your Banner identification number in order to activate your electronic services. This number was assigned to you when you applied for admission to Brown. If you need additional assistance, please contact the Computing Accounts and Passwords Office at 401-863-4357.
To return forms, the student must login to the Brown Health Services Patient Portal and upload the forms.
If you are unable to upload, fax the forms to 401-863-3321 or mail to:
Providence, RI 02912
If you have any questions about your medical forms, please refer to Frequently Asked Questions before contacting us.
Steps 1-5 are required for all students. Steps 6-8 only if indicated.