Health Forms for New Students in the 2014-2015 Academic Year

All students registered for one credit hour or more are eligible to use the services provided by University Health Service, regardless of whether they enroll in the University Medical Plan or have other insurance coverage.

All students, including the Lerner School of Medicine, Cleveland Institute of Art, Cleveland Institute of Music, Kent State University School of Podiatric Medicine, and the Masters Program in Anesthesia, are required to submit general information and and immunization record whether or not they plan on using University Health Service for their medical needs. The forms required for all incoming undergraduate, graduate, and professional students are listed by school and program below. Specific immunization requirements for the school are included in each of the different packets. All packets are available as interactive PDF files so some of the information can be typed on the forms before being printed. Once printed and completed, they should be mailed or faxed to the University Health Service.

Students enrolled in the Case School of Dentistry may be asked to send a copy of their immunizations to the school. Students also will be required to send the information to University Health Service.

Forms for students enrolling for the fall semester should be returned by July 1. For the spring semester, forms should be returned by January 1.

The forms for the Fall 2015 Semester will be available starting on April 15. The forms and the submission process are being substantially updated, and the forms linked to below will not be accepted for students starting then. The old version of the forms may be used for students who will be beginning classes during the Summer 2015 Semester.

Undergraduate Students
Graduate Students
Professional Students

If you have questions about the forms, please contact the following staff:

University Health Service

2145 Adelbert Road
216.368.2450
healthservice@case.edu

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