Parental Consent Form

Allow Health Services to provide health care to a student who is under 18 years of age.

This form must be completed if the student is under 18 years of age when they arrive on campus or at the start of the semester, even if the student will turn 18 during the academic year. Health Services cannot treat minors without written consent from a parent or guardian.

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Health Services

Student Life

University at Buffalo
Michael Hall, 3435 Main Street, South Campus
Buffalo, NY 14214

Phone: (716) 829-3316; Fax: (716) 829-2564