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 separate forms to the Health Center and Athletics
Physical examinations are NOT available on campus


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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