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Book Appointment (.png, 1K)
Book Appointment:
Request for Medical Records

Please complete the following for to retain all or part of your medical record. Form may be faxed or emailed to

Release form (.pdf, 24K)
Student Medical Forms (required for new students)

Meningitis form to be completed for students living on campus ONLY. Privacy practice document is to be read and confirmation of receipt signed at the bottom of the Health History form. If you have any questions regarding the privacy practices please contact the health center. 

Health History (.pdf, 187K)
Physical exam form (.pdf, 239K)
Immunization form (.docx, 28K)
Privacy practices (.pdf, 157K)
Meningococcal Meningitis Vaccine Verification or Waiver (.pdf, 120K)
Health Insurance Waiver/ Enrollment
United Healthcare Student Health Insurance Information (.pdf, 782K)
For all students enrolled in more than 12 credits, living on campus and all international students insurance is required for the academic term, which must be effective by August 1st
If you already have an insurance policy, you must waive the Wesleyan College health insurance. If you do not already have.
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