New Student Health Forms
Freshmen and Transfer Students: The following health forms must be received by July 1, 2015 (January 10th for spring semester students). 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 and Cynthia Maricle, Student Health Services Coordinator
- Handy Health Forms Checklist (pdf)
- Personal Information (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 and Important Information (pdf)
- Medi-Alert Form (pdf) Optional