Health Records Forms
The medical forms linked below are required by the Health Center prior to entering Hiram College.
- Pages 1 and 2 of the forms are to be filled out as complete as possible. These records are necessary for us to have in order for us to accurately treat the student.
- Pages 3 and 4 will need to be taken to your health care provider for completion of physical exam and immunization record.
- Your private health care provider must do this. The sports physical given to the athletes at the college is not acceptable for this record.
- Along with these forms, please enclose a copy of your
insurance and prescription cards.
Download the Health Record Forms
The completed forms should be mailed to:
Hiram College
Julia Church Health Center
P.O. Box 67
Hiram, OH 44234