Required Medical Forms for New Students

Health and Counseling Services use an electronic medical record system in our office. With this software, we are able to provide a secure electronic portal where students can complete online health forms, upload immunization records, physical forms, and insurance information directly to the system.  Students can also schedule appointments for counseling services via the portal.

Your first interaction with the Wellness Center will be submission of the health requirements that you must meet as an incoming student at Westminster College. As a new student, you will be providing your health information to us via the student health portal.

You will log in to the portal with your Westminster email and password.  

Some of the forms can be completed online once you are logged in to the portal and some documentation will need to be scanned and uploaded to the portal once completed.  Follow the directions below to submit each of the required documents. 

1. Immunization History  All students must comply with Westminster's immunization requirements.  If you are missing any of the required immunizations, you will be contacted via your Westminster email.  We will accept official immunization records from your health care provider, previous school or health department.

  • Log in to the student health portal.
  • Go to "My Forms" and select "Immunization History"
  • Enter the dates you received each dose of vaccine as per your immunization record
  • Upload a scanned copy of your immunization record to the portal (see instructions at the bottom of this page)

*Students must enter immunization dates via the patient portal and upload a copy of their immunization records in order to meet requirements.

2. Tuberculosis (TB) Screening Questionnaire 

3. Medical History

4. Emergency Contacts  

These forms provide our staff with an overview of your health status, past medical history, and who to contact in an emergency. All medical information is strictly confidential, and cannot be released to anyone (including your parents and/or professors) without your authorization.

These forms are to be completed by the student and do not need to be completed nor reviewed by your medical provider.

  • Log in to the student health portal
  • select "My Forms" in the menu bar near the top of the page
  • select and complete Medical History Form, Emergency Contact Form, and TB Screening Questionnaire

*Please note if you answer yes to any questions on the TB Screening Questionnaire, you will need to have a TB test when you have your physical exam completed.  If you are not high risk, or answer "no" to all questions, you do not need a TB test. 

 

In addition to the online forms discussed above, the following documents must be scanned and uploaded to the portal: 

1. Admission Physical Form (signed by health care provider and exam completed within the last 12 months).

2. Meningitis Waiver

These forms were mailed to your home address or are available for download on this page.

3. Copy of front and back of insurance cards - scan and upload copies of your insurance cards

4. Any additional documentation such as lab and x-ray results or other medical history 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

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, 51K)

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)