Student Health Center Downloadable Forms
| Form | Who | When |
Health History and Immunization Forms (Detailed Immunization Info can be found here) |
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|---|---|---|
| Combined Health History & Immunization Record Form (including Meningococcal Acknowledgement and Tubercular Info) | ALL* new students must complete this form | Students entering Winter 2011: Due by January 12, 2012 + |
| Immunization Record Form ONLY | ALL* new students must complete this form | Students entering Winter 2011: Due by January 12, 2012 + |
| Meningococcal Acknowledgement ONLY | ALL* new students must complete this form | Students entering Winter 2011: Due by January 12, 2012 + |
| Request for Religious Exception to Immunization |
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| Release Form | ||
| Authorization for Release of Protected Health Information (PHI) |
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*Exceptions: Students taking less than 4 credit hours
+ Failure to comply may result in $200 late fine and possible deregistration from classes.