Student Health Information

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Health Forms To Be Completed Online

Paper forms are no longer available

  • To register for your Patient Portal, you must have paid your deposit.
  • Go to MY HAZEN and log in with your Brockport NetID and password.
  • Need assistance? Email healthce@brockport.edu or call (585) 395-2414.
  • The MY HAZEN homepage will specify forms awaiting completion.

New NCAA Athletes

  • Complete New NCAA Athlete Health History Form
    • When completing the form, you must answer all the questions in detail WITHIN 20 MINUTES.
    • Incomplete forms cannot be saved or submitted.
    • Missed a question? -- You will be prompted to return to complete.
    • Once form is completed, click SUBMIT.

Non-Athlete Student

  • Complete Student Health History Form
    • When completing the form, you must answer all the questions in detail WITHIN 20 MINUTES.
    • Incomplete forms cannot be saved or submitted.
    • Missed a question? -- You will be prompted to return to complete.
    • Once form is completed, click SUBMIT.

New NCAA Athletes

  • Download the NCAA Physical Form for the pre-entrance physical to be completed by your Primary Care Provider.
    • Pre-entrance Physical:
      • Must be done within the last 6 months.
      • After form is completed by your PCP, scan and upload to MY HAZEN for review.

Returning Athletes

  • Complete Annual Update for Returning Athletes Form
    • When completing the form, you must answer all the questions in detail WITHIN 20 MINUTES.
    • Incomplete forms cannot be saved or submitted.
    • Missed a question? -- You will be prompted to return to complete.
    • Once form is completed, click SUBMIT.
  • Returning athletes DO NOT need to provide Sickle Cell status or physical.

All NCAA Athletes

  • You can check the status of your clearance to participate in your sport on MY HAZEN
    • Log In
    • Go to Immunizations
    • Select View History

Last Updated 8/15/18

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