Student Wellness Services

Queen's University
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Student Wellness Services

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Forms

Cartoon drawing of various forms and lettersAre you a new patient? Please complete the following forms and bring them to your first appointment:

Pre Entrance

Email Consent Form


Are you a new patient who is an international student? Please complete the following forms and bring them to your first appointment:

Pre-Entrance

Email Consent Form

Governing Law

Sun Life Claim Form


Are you a student from Quebec?

Students from Quebec are covered by their provincial health insurance plan but are required to fill out TWO Out of Province Claim Form for Quebec Residents for each visit, one for physician services and one for nursing services To save time at registration, these forms can be completed and signed beforehand and handed in at the time of the appointment.


Do you want your medical records transferred?

To have your records sent to another physician/location or to obtain copies of your medical records please complete the Authorization Consent to Release of Information indicating specifically what you require (eg., immunization record, entire chart, recent bloodwork) and drop it off at Student Health or send it by email to the following address bartonr@queensu.ca


Do you need a sick note?

Student Health cannot provide notes for those with acute minor infections or illnesses, whether they are seen by our physicians or not. 

It is hoped that students will be considered fairly, with empathy, and given the benefit of the doubt when reasonable. Most of us have, at some point, suffered minor illnesses and felt far too unwell to meet the demands facing us.To assist students with this process, Student Health Services provides a letter explaining this policy that students can print and take to their instructors. Letter outlining Sick Note Policy

Students can also fill out our Declaration of Illness Form and take it to their faculties/professors.


Are you requesting an appeal? Please fill out the following form and return it to Student Health:

Appeal Request Form