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Medical Forms

Report of Health Evaluation/ Report of Medical History

The Report of Health Evaluation must be submitted by all Resident students and Athletes. Athletes must submit one copy to Medical Services and one copy to the Athletic Department. All forms must be signed and stamped by the physician or they will not be accepted. These forms should be submitted prior to the student’s arrival on campus.

• Download Report of Health Evaluation
• Report of Medical History Form 

Immunization History

All commuter students must submit their Immunization History. This form must be signed and stamped by a physician or it will not be accepted. This record should be submitted prior to the student’s arrival on campus.

• Download Immunization History Form 

Medical Leave Request Form

Students requesting a medical leave of absence must fill out this form and submit it with proper medical documentation. The application must be filled out and signed by the student. If the student is incapable of signing, medical documentation to this effect must be attached and a parent or guardian may sign the form for the student.

• Download Instructions Form 
• Download Medical Leave Request Form 

Meningitis Vaccination Response Form

• Download form

Special Housing For Medical Reasons Form

• Download form