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

NYS Vaccination Clinics

UB's Health Services is unable to provide information about the NY State Department of Health’s COVID vaccination clinics being held at Harriman Hall on UB’s South Campus. For information about these clinics, including eligibility and to make an appointment, please call the NYS Health Department’s COVID vaccine hotline phone number: 1-833-697-4829 (1-833-NYS-4-VAX) or refer to their website.