- Health History Form
- MENINGOCOCCAL DISEASE AND COLLEGE STUDENTS
- HEPATITIS B AND COLLEGE STUDENTS
- Sickle Cell Form (only required of athletes)
These forms should be as complete as possible. This information is necessary as it helps us to accurately treat students, and immunization records (starting on page two of the Health History Form) are required by law.
The completed forms can be:
- *scanned and emailed to Health Center Coordinator, Nicole Coy at firstname.lastname@example.org
- printed and faxed to 330.569.5398
- printed and mailed to:
*You may take photos of your forms using your cell phone camera in order to scan them in and email them, but please be sure to take photos of ALL pages.
Monday-Friday 8:30 a.m.-5 p.m. (closed for lunch 12:30-1:30 p.m.)
We can be reached during regular office hours at 330.569.5418