Requirements & Forms

Please include your name and birthdate (and/or university ID number) on ALL forms/documents mailed/faxed to Student Health & Wellness. PDF format is preferred for emailed forms.

You need Adobe Acrobat to download the forms. Visit the Adobe Acrobat Reader website to get your free reader.

General students

Immunization Exemptions

Submit ONLY if you are requesting an exemption to the UI immunization requirement because of a medical condition or religious belief.  Students age 18 and older must complete and sign their own religious exemption form, including having it notarized.

Health Science students

For medical students doing clerkships/rotations:

International students

Minor students (under 18 years)

Health fee & insurance

Allergy patient information