New Student Health Form Information

All New Lawrence University Students will need to fill out a New Student Medical History and Physical Examination form.  This includes all incoming freshman and transfer students.  All health forms should be submitted by August 1.

All forms must be completed and signed by the student (or parent if student is not yet 18 years of age) and the physician prior to admission and entry into campus housing. Incomplete or unsigned forms will result in an incomplete health file.

All new to Lawrence students are required to have a physical within 1 year of the first day of classes.  Athletes are required to have a physical within six months of either (1) the first day of practice for fall sports or (2) the first day of classes for winter and spring sports.

Please have your immunizations prior to arrival on campus. Physical examinations are not available on campus.

All international students must have proof of health insurance coverage.  If you do not, you must enroll in the health plan negotiated by the university and provided through a local company.  If you have any questions about insurance or the medical forms, please contact our Director of International Student Services, Leah McSorley at leah.d.mcsorley@lawrence.edu.

The Affordable Care Act requires domestic student enrollment in a health insurance plan unless you qualify for an exemption from the law. This means that if you file taxes and do not have a qualified health insurance plan, you may be required to pay a tax penalty. For more information on obtaining health insurance through the marketplace go to HealthCare.gov.

Immunization Record Request

To obtain a copy of your immunization record after leaving Lawrence University:

Mail, email (jillian.r.drier@lawrence.edu) or fax (920-832-7488) the following release form to Health Services. The request needs to include your name, birth date, graduation year, written signature and the name, address or fax number of where you want the information mailed/faxed. We will process your request as soon as possible. Immunization Request Form.

Hepatitis B and Meningitis vaccines

Wisconsin State Statute 36.25(46) requires that all students who will be residing in a campus residence hall receive yearly information regarding the risks associated with Hepatitis B and Meningococcal disease and the effectiveness of the vaccines available to prevent these diseases. The student who resides in campus housing must affirm whether he or she has received vaccinations against Hepatitis B and/or Meningococcal disease, and must provide the dates of the vaccinations, if any. The parents of minor students must provide this information. Please have these dates available when you check into housing.

Lawrence University requires that the Hepatitis B vaccine be initiated as a condition for enrollment. Immunization for Meningitis is strongly encouraged. 

For more information on these diseases and immunizations follow the links for Hepatitis B and Meningitis.

Returning Your Forms

The New Student Medical History and Physical Examination Form can be delivered to the Health and Wellness Center in one of three ways:

Mail:
Health and Wellness Department
711 E. Boldt Way, SPC 3
Appleton, WI 54911-5699

 

Fax:
920-832-7488

 

E-mail:
jillian.r.drier@lawrence.edu

 

 

 

You only need to send them in one manner, for example, if you fax a form, you do not need to mail the hard copy. You will be informed if a form is unreadable or if we need an additional copy.

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