Required Enrollment Health Forms for New Students

January entry - Due January 1

August entry - Due July 1

Your first interaction with the Wellness Center will be submission of your enrollment health forms.

As a new student, you will be providing your health information to us via the student health portal. If you are a student athlete, you will also need to submit health information to athletics as we have separate electronic health records.

There are multiple steps for completion of your enrollment health information. Once the information is verified as complete, staff will manually mark your new student checklist. 

Step 1:

There are five online questionnaires which you will find under "my forms" in the menu of the student health portal. A few of these forms will prompt you to upload the required documentation, i.e. images of immunization lists, health insurance cards, etc. 

Follow the directions below to submit each of the required online forms: 

  1. Emergency Contacts - complete and submit
  2. Health Insurance Information - this form will prompt you to upload an image of the front and back of your health insurance card.
  3. Medical History - complete and submit
  4. Tuberculosis (TB) Screening Questionnaire - If you answer yes to any of the questions, you will need to get a TB test at your physical exam appointment. If you answer no to all questions, you do not need a TB test.
  5. Immunization History - Enter the dates you received vaccines into the form. Upload a copy of your vacccine record when prompted. 

 

Step 2: 

Upload your completed physical exam form (exam within the past 12 months)

Upload any additional health documentation you would like to share

 

To upload forms:

  • Scan the documents and save to your computer (file type should be PNG, JPEG, PDF, or TIFF).
  • Log in to the student health portal
  • Click on "Document Upload" in the menu bar near the top of the page
  • Select the Document Type from the drop down menu
  • Locate the scanned document on your computer and click "SAVE"
  • Repeat for each Document Type

All medical information is strictly confidential, and cannot be released to anyone (including your parents and/or professors) without your authorization.

For questions regarding Wellness Center services or enrollment health forms, contact wellnesscenter@westminster.edu

Forms

This form is required of all new Westminster students.  Please print and take with you to your physical appointment with your health care provider.  Scan and upload the completed form to the student health web portal.

(.pdf, 35K)

Under the terms of the College and University Student Vaccination Act of the state of Pennsylvania, students living in campus housing must be immunized against meningococcal disease or sign a waiver that they have received detailed information on the risks associated with meningococcal disease and the availability and the effectiveness of vaccine and that they choose not to be vaccinated.

(.pdf, 314K)