Incoming Student Health Form Information

All incoming students must fill out a Medical History and Physical Examination form. Forms should be submitted to the Health Center by August 1.  *Missed Deadline: turn forms in as soon as they are complete to avoid a hold your student registration. 

Medical History and Physical Form

**Please allow time to processes paperwork. Check student's account for any updates.  

CHECKLIST for Incoming Student Health Form.
Due by August 1st
  • Complete and submit:
    • Immunizations forms 
    • Medical History form 
    • Physical are required to have a physical within 1 year of the first day of classes. 
  • Be sure all forms are signed by student or parent of students under 18yo
  • Attach a copy of the front and back of your insurance card- Check your Medical Insurance covers Appleton. Find more information regarding purchasing insurance on our website.
  • Sign the Hepatitis B/Meningitis form acknowledging the increased risks of disease living on a college campus
  • Discuss and plan for any prescriptions needed during the academic year with your provider


**Athletes must submit forms to Athletics and the Health Center separately**


If a vaccine is unavailable to you, you will be expected to get that vaccine at the Health Center upon arrival to campus or sign a waiver form. Contact the Health Center for cost information.

Questions or Concerns     920-832-6574

Returning Forms

You have 3 options on submitting all Medical History and Physical Examination forms. Choose which best works for you. 

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


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