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Required Health Forms

All new students must have a pre-entrance medical record, current physical examination and immunization records on file in the Health Center before the first day of class.  Also, if you do not need Judson student insurance, a waiver must be on file.  See forms below to fill these out online or for a printable form that can be mailed, faxed or carried in to the Health Center.  
  • Pre-Entrance Medical Form - Forms are available below. 
  • Physical Exam - Must have been completed within 12 months prior to the first day of classes.  If you need a current physical, this can be done at your local doctor's office, a walk-in clinic or the Judson Health Center.  At the Health Center, the charge is $50.  This form is available below for you to print; it can not be completed online because a doctor's signature is required.
  •  Immunization Record A mandate from the State of Illinois requires:  
             1. Td (Tetanus/diphtheria) - must be within the past 10 years
             2.  MMR (measles, mumps, rubella) - 2 doses required
             3.  Meningococcal Vaccine - 1 dose required on or after 16 years of age

A copy of these can be obtained from your doctor's office or your high school. 

  • Insurance - You have two options for insurance:  
    1. Personal Insurance - If you have your own insurance or are covered under someone else's insurance (i.e. parents, spouse), an insurance waiver must be completed before the 10th day of class. Without this waiver on file, you will automatically be placed on  Judson student insurance and will be charged accordingly.
    2. Judson Student Insurance - If you need Judson student insurance, an insurance form needs to be completed at the Health Center. You will be issued an insurance card and given a booklet detailing the coverage. Your student account will be charged. Fees for the 2019-2020 school year are:  Fall-$926 and Spring/Summer-$1,287.  Please call the Health Center with any questions.