Yale Health Form


The information provided in the form will be treated with discretion and used for the participants' benefit. Omitting information puts the participant's health at risk and may result in medical complications related to the lack of medical history.


Watch the video for a step-by-step guide on filling out the health form for Yale.


Detailed Guide to Filling Out Yale Health Form


Log In


  • Before starting, ensure you have your student ID handy.
  • Enter your student ID on the login page and click the login button.

Read Important Statements


  • Review Instructions: Carefully read through all provided instructions.
  • Visit Each Section: Go through each section of the form and complete all required information.
  • Save Your Progress: You can save your progress as you go, but ensure you have all necessary documents beforehand.

Prepare Necessary Documents


  • Student Headshot: a casual photo that accurately represents the student’s current appearance.
  • Health Insurance Policy: Include the policy number and U.S. contact phone number.
  • Immunization Record: include details such as the month, day, and year of each vaccine received, as well as the number of doses administered.

Download and Sign Documents


  • Permission to Treat Document (download HERE): the document is mandatory and must be written in English and signed by the parent / legal guardian. Filling and signing can only be done by hand

  • Health Exam Record (download HERE): the document is mandatory for ALL participants of a program at Yale and must be written in English and signed by the prescriber. Filling and signing can be done electronically or by hand.

Address Special Health Needs


  • Individual Plan of Care (download HERE): ONLY if the participant has any disabilities or special health care needs the document is mandatory and must be written in English and signed by the prescriber. Filling and signing can be done electronically or by hand.

  • Authorization for the Administration of Medication (download HERE): ONLY if the participant is required to be administered any medication/drug the document is mandatory and must be written in English and signed by the parent /legal guardian. Filling and signing can be done electronically or by hand. 

  • A written order by an Authorized Prescriber and Written training plan: ONLY if the Authorization for the Administration of Medication includes a drug that needs to be administered other than oral (topical, inhalant, injectable by a premeasured commercially prepared auto-injector). The document must be in English and follow the guidance in this document (download HERE).

Filling out the Form:


Step 1: Personal Information


  • Email and Phone: Confirm your email and cell phone number.

  • Upload Headshot: Upload the student’s headshot

  • Emergency Contact and Insurance:

    • Add emergency contact telephone number.
    • Include health insurance policy details. Learn More
    • Provide the travel insurance company's phone number in the U.S.


Step 2: Health History


  • Dropdown Menu: Use the dropdown menu to select yes or no for each health-related question.

  • Details for Yes Answers: Provide detailed information for any questions answered with "yes," including the year and participant's age during the event.

Step 3: Health Exam Record


  • Allergies: Indicate any allergies and provide explanations if required.

  • Dietary Restrictions: Use the dropdown menu to indicate any dietary restrictions and provide details if necessary.

Please be advised that parents have to contact the airline directly for any special meal requests for the flights. They will be able to assist you in arranging any dietary accommodations for your child's journey.


  • Medical and Emotional Conditions

Known Conditions: Answer questions regarding any known medical or emotional conditions.

Provide Explanations: Offer detailed explanations and additional information if applicable.




Step 4: Medical Authorizations



  • Medication Needs: Indicate if any prescription or over-the-counter medications are needed during camp.
  • Medication Details: Provide information about the medication, dosage, administration method, and possible side effects.



  • Special Medications: For medications administered other than orally, upload a written order by the prescriber and a written training plan according to the Guidance for Medications.


Step 5: Immunization Records


  • Vaccine Details: Provide the month, day, year, and number of doses received for each vaccine.
  • Please fill out the form with your vaccine record. You don't need to upload or send the vaccine report to us.

  • COVID-19 Proof: Upload COVID-19 vaccination proof if applicable.


Step 6: Agreements and Code of Conduct


  • Participant Guide and Code of Conduct: Read this document carefully. Scroll down the entire document and sign digitally by checking the box and entering your name.
  • General Agreement: Scroll down the entire document and read to sign the general agreement document by writing your name and confirming.

Step 7: Review and Submit


  • Review Details: Double-check all entered information for accuracy.
  • Declaration: Check the box declaring all provided information is true, accurate, and complete.

  • Submit Form: Click the submit button.


Confirmation


  • Confirmation Message: Ensure you see the confirmation message that your information has been successfully submitted.


  • Log Out: Once completed, log out of the system.



  • Troubleshooting: If you do not see the confirmation message, check your internet connection and try submitting again.



The university staff will check that everything has been completed and in case that's not been done, then we will contact you. Please feel free to contact us at contact@eduexplora.com if you have any further questions.

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