Health Forms and Policies

In order to provide the best possible care for you while at Dickinson, the college requires you and your health care provider complete the Student Health forms. This information will become part of your permanent and confidential medical record which will be file in the Wellness Center - Health Services office.

Dickinson College requires that incoming students complete with the Pre-Admission Health Policy as listed below:

You are required to have a physical exam dated no more than 12 months from matriculation and submit the required forms by July 1 for the fall semester and Jan. 2 for the spring semester.

Incoming Students

Required Forms

Online

student to complete online via dickinson gateway:

• Health History Record
(If you are unable to complete online through Gateway, please click Health History Record to download and print. We request that you do not send a hard copy unless you were unable to complete online.

Printable

student to download and print health forms:

• Welcome Letter

• Pre-Matriculation Immunization Policy

• Medical/Health Forms Checklist

• Guidelines for Treatment

• Privacy Statement

• Immunization Record

• Physical Exam Record

• TB Screening

student to take these forms to physical exam appointment for health care provider to complete:

• Immunization Record

• Physical Exam Record

• TB Screening

student to submit guidelines for treatment/privacy statement and health care provider's forms to our office by fax, e-mail or postal mail to the following contact information:

Dickinson College
Wellness Center - Health Services
ATTN: Beth Graham, Office Manager
P.O. Box 1773
Carlisle, PA 17013
Fax: 717-245-1938
health@dickinson.edu

Students who have not completed or have incomplete health forms will not be able to directly check into their housing assignment upon arrival to campus.

All medical forms are available by clicking health forms. If you cannot retrieve them online, please contact the Wellness Center - Health Services by phone (717-245-1663) or e-mail (health@dickinson.edu) and we will send them to you.

ALL STUDENTS

Meningitis Information

Student Health Insurance information

Allergy Injection forms

Summary of Care form

Medical Confidentiality Laws in Pennsylvania

Don't Forget - What you should bring to college

Special Housing Request based on medical, psychological or disability needs are handled through the Office of Disability Services.

If you are interested in completing an advanced directive, please visit this website for more information and forms: http://www.caringinfo.org/PlanningAhead/AdvanceDirectives/Stateaddownload.htm

Please contact us if you have any questions, by phone 717-245-1663 or e-mail health@dickinson.edu.