Need a Form for Health Services?
Student or Employee Injury Forms
If you are injured on campus while at work or attending De Anza College, you may be referred to an occupational health clinic for treatment. Learn more about the required workers comp forms by visiting the Reporting a Campus Injury webpage.
Most health forms are now available through the PyraMED health portal. There are two
ways to access the portal:
- Log in to MyPortal, then locate the Health Services card and click on De Anza Student Health Services
or - Visit deanza.studenthealthportal.com and log in with your CWID and MyPortal password.
Caregivers Authorization Affidavit
A Caregiver’s Authorization Affidavit is provided because of California’s recognition that adults who have minors living with them are “caregivers,” who often want and need to take some responsibility for the minor’s education and medical care.
A relative who has signed a Caregiver’s Authorization Affidavit may enroll a child in public school, make school-related medical decisions, and make other important decisions on the minor’s behalf. Non-relatives may also use this form to enroll a child in school and to receive school related medical treatment.
According to California law, schools and medical care providers must accept this form if it completed correctly. It is important to note that only the caregiver is required to sign the form, not the minor’s parents.
Required Steps for the Caregiver
- Complete the Caregiver's Authorization Affidavit form (available through the PyraMED health portal)
- Provide copy of caregiver's California driver's license
- Caregiver must sign the form and have it notarized before submitting it