See our COVID-19 web page for safety protocols and frequently asked questions for the Manhattanville Community for the 2021-2022 academic year. Our dashboard can be viewed here.
Please contact us at (914)323-7277 or email shac@mville.edu for an explanation of our forms or if you have questions about how to complete a form.
Health Forms
- Undergraduate Student Health Packet
Consent Form for Treatment of Minors at SHAC- Graduate and Part Time Student Health Form
- Exemption to Immunization Requirements
- These forms are uploaded here
Counseling Forms
- Consent to Obtain Protected Health Information
- Consent to Release Protected Health Information
- Medical Leave of Absence
- Medical Leave of Absence Policy
- Policy for Treatment of Minors
- Treatment of Minors in Counseling (Consent Form)
- Provider Evaluation after Medical Leave of Absence
- Request to be a Referral to SHAC
- Student Health and Counseling Acknowledgement