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Health History Form

Your personal health information is considered confidential and will be protected by the HIPAA and FERPA laws that govern higher educational institutions. Please take a moment to look over our HIPAA Policy that is included on the last page. By typing your name at the completion of this document, you are acknowledging that you have received the HIPAA Policy governing Campus Health and are in agreement to it.
























Additional instructions for the previous question. There are additional immunization requirements for some majors (including education, nursing, physician assistant and international rescue and relief).




Important Information about the next question. Parent or guardian information