In order to provide the best possible care for you while at Dickinson, the College requires you and your healthcare provider complete the Health Information forms. This information will become part of your confidential health record, which will be on file with Health Services at the Wellness Center.
You are required to have a physical exam and submit all forms by July 1, 2014. Please call your healthcare provider as soon as possible to schedule an appointment.
To Complete Online (link via Dickinson Gateway health forms)
- Medical/Health History
- Immunization patient form
To Download & Print (link via Dickinson Gateway health forms) for Healthcare Provider to complete during physical exam:
- Medical Record healthcare provider form- immunization record, physical exam record, and TB screening
Important: Students must complete the medical/health history and immunization forms online AND submit the medical record healthcare provider form.
Ways to Submit:
Mail: Dickinson College Student Health Services P.O. Box 1773, Carlisle, PA 17013
Upload: link via Dickinson Gateway health forms
The state of Pennsylvania requires all students to have current immunization against meningitis or sign a meningitis waiver form in order to be housed on campus. If you do not get the vaccine and/or required booster, a waiver form must be completed which is available on the online medical/health history form. If you are unable to complete online, e-mail email@example.com and we will send to your Dickinson e-mail.
Allergy injections or other medical conditions
If you are under medical care at present for an ongoing or chronic medical condition, a summary from your health-care provider should be sent to the director of Student Health Services. If you are currently receiving allergy injections and plan to continue while at Dickinson, we will need your physician to provide additional information through the allergy injection form.
All students are eligible to be seen by Health Services at the Wellness Center at no cost for the visit, regardless of health insurance status. There may be minor fees associated with prescription medication and lab work done on site. At this time, Health Services does not submit claims to insurance companies. If any fees apply, a receipt is provided to the student for submission to their insurance company.
Students are required to have health insurance that will cover them while at school, in case referrals to specialists or emergency room visits are necessary. If you belong to a managed care plan (HMO, PPO, POS), please speak with your primary care provider or a service representative to confirm you will be covered while in Carlisle. This is important because many managed care plans will not provide coverage if the patient is out of the service area, or if care is provided by an "out-of-network" provider. In this case you would need to enroll in the Student Health Insurance plan.
In addition, students should remember to bring their health insurance cards to campus in case of an emergency.
Additional Student Health Information
If you have any questions concerning the health forms or services, visit Wellness Center or email firstname.lastname@example.org. If you have a health condition that may impact you academically, we recommend that you visit the Disability Services Web site and send a message to email@example.com.
Note: Please make copies of all forms for your records before sending the originals. Please do not leave the Medical Records form at your doctor's office for them to mail. Too often, we never receive them.
Maintaining your health during your college years is an extremely important factor in being productive and successful. We look forward to helping you make your time at Dickinson a healthy and happy experience.
Reminder: July 1, 2014 is the deadline to have all health-related forms completed and returned.