Student Health Form Requirements
Health Services seeks to ensure a safe, healthy environment for the entire campus community. In order to do so, there are forms that are required of every undergrad and seminaian which you will find for downloading below. Please read everything carefully and submit the information by June 30.
Required Health Forms - New Students - Due June 30
For new undergraduate students and seminarians entering the Mount in the fall, the following forms are due June 30.
Print and complete these required forms:
► Cover Letter (.pdf) Important to read first
► Health History Form (.pdf page 1)
► Physical Examination Form (.pdf page 2)
► Immunization Form (.pdf page 3)
► Meningitis Information/Waiver * (.pdf page 4)
► Emergency Information (.pdf page 5)
* Effective June 1, 2000, Maryland law requires that an individual enrolled in an institution of higher education in Maryland who resides in on-campus student housing must be vaccinated against meningococcal disease.
Please mail your forms to:
Mount St. Mary's University
Attention: Health Services
16300 Old Emmitsburg Road
Emmitsburg, MD 21727
Faxed forms are not accepted!
Returning Students and Seminarians:
Returning students and seminarians must do the following:
► Inform Health Services of any changes in your health insurance plan;
► Inform Health Services of any changes in medications or diagnosis;
► Update your Emergency Contact information.
Health Services seeks to insure a safe, healthy environment for the entire campus community, we cannot impress upon you enough the importance of getting this information to us in a timely manner.
If you have any questions about Health Services or what is required, please call 301-447-5288 or email firstname.lastname@example.org. The Health Services staff is looking forward to having you as a part of the Mount St. Mary’s University family again.