Dear New Amherst Students and Families,
Welcome to Amherst College. Whether you are on campus this fall or learning remotely, the staff at the Health Center wants to help address your health concerns. We need to receive certain information from you in order to provide appropriate advice and care, to promote the goals of the College, and to comply with state law and regulations. Please refer to the list below in order to submit all of the necessary completed information. In addition, there may be more health information required prior to the start of the fall semester regarding COVID-19. We will keep you informed of any changes.
Forms are available for download on the Patient Portal. You can log into the patient portal using your Amherst College credentials, once your Amherst credentials are set-up. When completed, the forms should be uploaded back to the portal. If you do not have your credentials set-up yet, but need the forms, you can print them from the New Student First Year Form 2020 link below. You can also submit the forms via email, fax or mail. It is imperative that we receive completed forms by July 13, 2020. If your health file is not complete, your course registration will be placed on hold.
Required Health Forms for All First Year or Transfer Students
- New Student First Year Form 2020
Forms must be signed or stamped by your medical provider. Massachusetts law requires up-to-date immunizations as outlined in the forms. These forms are only necessary once, when arriving for your first year.
- Insurance Information
The student insurance health forms, insurance waiver, and other materials are now available at the Gallagher insurance website (see Gallagher Student Insurance for more details.) If you have waived the Amherst College student insurance plan, please log on to the Patient Portal and enter your insurance information in the 'Insurance' tab of the portal. There, you can upload a photocopy of both sides of your health insurance ID card and pharmacy benefit ID card. (Click here for example). NOTE: Please upload your insurance information that you will be using for the coming academic year. Please do not upload your current insurance information if it is not going to be used.
Thank you for your assistance in meeting these college requirements. If you have any questions regarding these forms, please contact the Keefe Health Center’s Office at 413-542-2267 or email@example.com.
Keefe Health Center
PO Box 5000
95 College Street
Amherst MA 01002
Phone (413) 542-2267
Fax (413) 542-2647