Health Forms FAQs

General FAQs about the Electronic Form

+How do I complete my health forms?

June 1st, 2018 FY Health Forms will be accessible through Garnet Gateway

  1. Consent to Medical Treatment Form:
    1. This form be can filled out completely online. Only a signature is required to complete this form.
  2. Health History Form:
    1. This form be can filled out completely online. In most cases the information needed to complete this form can be obtained via your Parents/Guardians
    2. To view a completed example, click here.
  3. TB Assessment Form:
    1. If you answer “No” to the first three questions at the top of the form you can electronically sign and submit it. That’s all you need to do. To view a completed example, click here.
    2. However, if you answer “yes” to any of the first three questions you will need to have your healthcare provider fill out the lower half of the form.
    3. You can print out the form, have it completed by your healthcare provider and have either them or you return it to Bates Health Services by one of the following:
          • Attach it Electronically to the Online TB Form:
                  – Start a new TB Form online and attach your completed TB form.
                  – If you don’t have it electronically you can use your phone/tablet to take a snapshot of it and attach that to the online TB Form.
          • Mail to:
            Bates Health Services
            31 Campus Ave.
            Lewiston, ME 04240
    4. Immunization Form:
      1. This form must be printed and completed by your healthcare provider. Once completed, you can send it to us by one of three methods:
          • Attach it Electronically to the Online Immunization Form:
                  – Start a new Immunization Form online and attach your completed Immunization Form.
                  – If you don’t have it electronically you can use your phone to take a snapshot of it and attach that to the online Immunization Form.
          • Mail it to:
            Bates Health Services
            31 Campus Ave.
            Lewiston, ME 04240


    +I missed the July 1st deadline. What should I do?

    • First, take a deep breath
    • Second, complete your forms as quickly as possible
    • If you need help don’t hesitate to contact Health Services


    +What information will I need to complete the forms?

    • Your Personal Contact Information
    • Parent/Guardian Contact Information
    • Emergency Contact Information for at least one person
    • Place of Birth
    • Bates Email Address
    • Family Medical history
    • Personal Medical history
    • Medications
    • Hospitalizations


    +Can I print the completed electronic health form?

    • Yes, when you click on “Finish” to complete the form you will have an option to “Show” the document. You can then print it.
    • You will also receive a copy of the form in your email so you can view it and print it after completing the form


    +What if I am under 18 years old?

    • You are required to have a Parent/Guardian fill out the Electronic Health Form.
      • There will be two roles to complete:
        • For the “Student” Role, the Student’s name and Bates Email address should be entered.
        • For the “Parent/Guardian” Role, the name of the Parent/Guardian and their associated email address should be entered.

          ***The form will be sent to the email address used for the Parent/Guardian***

      • The student can first fill in all the information in the form, sign it and it will be automatically sent to the Parent/Guardian’s email address.

      • The Parent/Guardian can sign the form and it will be sent to Bates Health Services.


    TB Assessment Form

    +Is it possible to print the TB form so I can send it to my PCP?

    Yes, you can print the form using one of the following approaches:


    +Once my physician completes the bottom section, how do I send it to Bates Health Services?

  4. You can print out the form, have it completed by your healthcare provider and have either them or you return it to Bates Health Services by one of the following:
        • Attach it Electronically to the Online TB Form:
                – Start a new TB Form online and attach your completed TB form.
                – If you don’t have it electronically you can use your phone/tablet to take a snapshot of it and attach that to the online TB Form.
        • Mail to:
          Bates Health Services
          31 Campus Ave.
          Lewiston, ME 04240

  5. Immunization Form

    +Once I have my records from my healthcare provider, how do I send it to Bates Health Services?

        • Attach it Electronically to the Online Immunization Form:
                – Start a new Electronic Immunization Form online by using the link on the main site and attach your Immunization records to the Form. Within the electronic form you will see an icon that you can select to upload your documents. .
                – If you don’t have your immunization records electronically you can use your phone/device to take a snapshot/scan of it and attach that to the online Immunization Form.
        • You can also Mail it to Health Services:
          Mail it to:
          Bates Health Services
          31 Campus Ave.
          Lewiston, ME 04240