New Student Health Forms
Freshmen and Transfer Students: The following health forms must be received by July 1, 2014. If the required medical information is not received by the due date, your course registration may be at risk.
Download and return your completed forms via US mail to Cynthia Maricle, RN, Student Health Services Coordinator, Wheaton College, Norton, MA 02766. Faxing is unreliable and not recommended. Please make copies for your records.
Welcome Letter from Jeff Klug, Associate Dean of Students and Director of Counseling and Health Services
- Handy Health Forms Checklist (pdf)
- Personal Information Form (pdf)
- Physical Exam & Immunization Record (pdf) Office copies accepted. Hepatitis B, MMR, and Varicella vaccine series must be initiated before arriving on campus.
- TB Risk Questionnaire (pdf)
- Health History (pdf)
- Health Insurance Checklist (pdf)
- Norton Medical Center Registration Form (pdf)
- Study Memorial Hospital Disposition Information Form (pdf)
- Meningitis Waiver Form and Important Information (pdf)
All newly enrolled full-time students must provide written documentation of one dose of Menomune (MPSV4) in the past 5 years OR a dose of Menactra (MCV4) at any time in the past (unless they have signed a medical or religious exemption) OR must sign this waiver form indicating that they decline the vaccine.
- Medi-Alert Form (pdf) Optional