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Undergraduate Students

All full-time and part-time undergraduate students who are matriculated in a degree program are required to complete the following forms:

  • Electronic Health History form
  • Electronic Insurance form (only if you are insured)
  • Electronic Notice of Privacy Practices form
  • Electronic Permission for Treatment Agreement (18 years or older) OR Consent for Treatment of a Minor (parent/guardian must download, print and submit)
  • Electronic Options for Meningitis Compliance (required for resident students) OR Options for Meningitis Compliance for a Minor (parent/guardian must download, print and submit)
  • Electronic Vaccine History form (no documentation is required for dates entered)

Completion of the required medical forms must be done whether a student resides in campus housing or a private residence and regardless of intent to utilize Clinical Services.  Please note that failure to complete this information in a timely fashion may limit your ability to register for future coursework or view your transcript.

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You will need to enter your university network username, password and date of birth. If you cannot locate or remember this information, contact the IT Help Desk at 610-683-1511.