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Health Forms for New Students

Health forms for new students are due by July 15 for fall semester entrants and January 15 for spring semester entrants.

Mail forms to: Hampshire Health and Counseling, 893 West Street, Amherst, MA 01002 OR Fax to 413.559.5583 OR scan and email to

For questions about health and counseling services, student health insurance, or required forms call 413.559.5458, email, or visit our web page.

All medical care and counseling provided by the health center is provided at no additional charge to actively enrolled Hampshire College students; however, there are additional charges for laboratory tests, x-rays, prescription medications, and some immunizations received at the health center. See list of current fees.

Some students may benefit from off-campus psychotherapy that is beyond the limits of our counseling services. Our staff psychologists will help facilitate referrals to local therapists or psychiatrists as needed.

Massachusetts State Law requires that all college students are covered by health insurance. Hampshire College works with the Gallagher-Koster company to offer a student insurance plan through Harvard Pilgrim that is tailored to the needs of our students. The Student Health Insurance Plan will be billed along with your tuition. If you have comparable medical coverage through another insurance plan, you can waive this fee between July 1-August 10. Examine the student insurance plan and your co-payments, deductibles, and out-of-network exclusions very carefully as you make a decision about coverage while away at college.

Students should read the Notice of Privacy Practices (pdf) to understand the health and counseling services commitment to patient privacy and confidentiality.

Healthcare Proxy Forms
Students are encouraged (but not required) to complete and send an Advanced Directive Form and Healthcare Proxy (pdf). Advance directives are legal documents that protect your right to refuse medical treatment you do not want or to request treatment you do want, in the event you lose the ability to make decisions yourself. A healthcare proxy form lets you name someone to make decisions about your medical care--including decisions about life support--if you can no longer speak for yourself. An advance directive is legally binding only if the person completing it is a competent adult, at least 18 years old.


© 2014 Hampshire College 893 West Street Amherst, MA 01002 . 413.549.4600