Forms

One health form will be mailed to you, or you may download the form by clicking on the links to the right.  You will receive a Medical History and Examination Form, which 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 international students should be advised that they will need additional lab work (a blood test) upon arrival at Lawrence if their Tuberculosis forms (TB Screening Questionnaire & TB Risk Assessment) are not correctly completed and/or the TB Risk Assessment is not signed by a physician. This test will cost approximately $110.00 and may or may not be covered by your insurance.

Please have your immunizations prior to arrival on campus.  Also, be aware that physical exams are not available on campus.
Mail forms to:

Buchanan Kiewit Wellness Center
Health Services
Lawrence University
711 East Boldt Way, SPC #03
Appleton, WI 54911-5626

Why?

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.  Both vaccines are available on campus at the Landis Health Center, but it is recommended that students receive them prior to coming to campus.