Required Health Forms

ALL new students in the Traditional Undergraduate programs* must have the following forms on file with the Wellness Center before the first day of class of the semester you are entering:

  • Immunization Record
  • Physical Examination (must be within 1 year of the first day of class)
  • Health Insurance Waiver
  • Copy of Health Insurance Card
  • Pre-Entrance Medical Record

See forms below to fill these out online. You can also download a printable form within each section. Then go to the Document Upload section below to upload them. They can also be mailed or faxed to the Wellness Center (please see the Wellness Center page for mailing address and fax number).

**Failure to complete any of these forms and submit them on time will result in a Health Hold on your account and could prevent you from registering for classes. Additionally, failure to provide a copy of your health insurance information if you are using your own insurance will result in a charge for JU Student Health Insurance.

*These forms are NOT required for Adult Professional, Certificate or Graduate students.


Immunization Record

Physical Examination

Health Insurance Waiver

Pre-Entrance Medical Record

Document Upload

Consent to Treat Minor

If a student is under the age of 18 years old, a parent/guardian can complete the Consent to Treat Minor Child form below in order to provide permission for their child to receive treatment and/or medical recommendations from appropriate medical personnel.


Medical/Religious Immunization Exemption

Students are eligible to complete a request for exemption from immunization requirements on medical or religious grounds. Simply complete and sign the applicable form below in lieu of providing immunization records.


Release of Health Information

The Athletics department and Health Services department require similar health documents for incoming students. Complete the Release of Health Information form if you would like these departments to be able to share certain documents between departments.


Consent to Treat Minor

Immunization Exemption

Release of Health Information