Confidentiality and Your Privacy

Medical confidentiality is assured for all care and services at SHS, except in cases where the safety of the student or others is at risk, or as required by law (such as mandated reporting of certain infectious diseases and abuse). This means that no detailed information will be transmitted to others without the student's written consent or direction, except as noted above. The Student Health Form information may be shared with appropriate University personnel on a need to know basis.

All Patient information is held in strict confidence according to FERPA guidelines.  A confidential medical record is established and maintained for every patient. Records well be released only with a student's signed written request.

Health Service Disclosure Forms

A student can request their medical records be sent from or to SHS after completing the following consent forms for records release.  Record requests are processed in the order received and generally require five to seven business days to complete. If you have additional questions regarding records, please contact vdelani@lesley.edu

• Complete and sign this disclosure form [pdf] authorization for Lesley Student Health to disclose health information. Note: Please use this form to request your medical records sent to you or an outside provider.
• Complete and sign this disclosure form [pdf] authorization for release of medical information. Note: Please use this form to request that your records are sent from an outside provider or facility to Lesley Student Health Service.
• Complete and sign this immunization disclosure form for release of immunization records.
• Disclosure forms must be complete with correct phone/fax numbers, address, contact information and complete signature.
• Signed and completed disclosure forms can be emailed to vdelani@lesley.edu; faxed to 617.349.8225 or mailed to Lesley Student Health Service, 29 Everett Street, Cambridge, Ma 02138.