Forms
Required for Registration
Release of Information
This is not a mandatory form. Just complete if you need one of the following:
- You seek care at Curry Health Center and need previous health records sent to Curry Health Center.
- You want Curry Health Center to send your health records to another location.
Authorization for Release of Health Information
Insurance Forms
Refuse Insurance Form-International Students
Please, print out and complete the Refuse Insurance Form-International (under forms), upload completed form with the accompanying official documentation that is required. Your documentation will be reviewed. If the requirements are met, the charge for the student insurance plan will be credited back to your student account. If more information is needed, you will be notified via your UM student email. Please, allow 2-3 business days for processing.
Refuse Insurance Form (US Citizen)
Instructions to upload completed forms to the Health Portal:
- Log into your account on Health Portal (you will need your Cyberbear credentials)
- Click on "Uploads"
- Scroll to bottom to chose document you are uploading
- Select "Insurance Documentation"
- Select file to upload
- Upload
- Send email as indicated after upload of file. The information uploaded will not be processed otherwise.
- Once form has been processed you will be contacted by Student Insurance representative.
Class Excuse: COVID-19
Please use the following form if your instructor requires an excuse from class and you are experiencing COVID-19 symptoms and must miss class: