“Important


Health Forms


Send it in early! Please complete the following record four (4) weeks prior to you arriving on campus. If you have questions please contact the Send it in early! Please complete the following record four (4) weeks prior to you arriving on campus. If you have questions please contact the Health and Wellness office 650 Maryville University Drive St. Louis, MO 63141 Telephone: 314-529-9556 Fax is 314-529-9906 smcintyre@maryville.edu or nurspam@maryville.edu

Health Record Form is required to be on file in the Health and Wellness office for the following students:

Students Living in University Housing

Please send 4 weeks before move in:

  • Physical exam less than 1 year old, on file (not required yearly)
  • Documentation of 2 doses of Measles, Mumps and Rubella, Tetanus/diphtheira or Tdap within the past 10 years and Meningitis vaccination or formal declination Meningitis Vaccine Documentation or Waiver form
  • Meningitis Information Sheet All students living in University housing must either get a meningitis vaccination or formally decline; Indicate if you had chickenpox or document 2 doses of Varivax
  • Tuberculosis testing within the past year with results (see form for details)
  • Student Health Form

Division II Athletes, Dance and Cheerleaders

If you live on campus - you will need a TB test/results and fill out the meningitis form too!  Send in 4 weeks before moving in.  NOTE:  NCAA is voting in January 2012 to decide if ALL athletes need to have a sickle cell test done and documented on the health form.  Will update form after decision is made.

  • Annual physical exam while participating in Division II athletics, Dance or Cheerleading
  • Documentation of 2 doses of Measles, Mumps and Rubella, Tetanus/diphtheira or Tdap within past 10 years on file and note Chickenpox disease or document 2 doses of Varivax (Chickenpox vaccine)
  • Student Health Form

Health Professional Students in Clinicals

See details on form or talk with your advisor about the requirements that will be due before you engage in your clinical/practica experience.  If you are not living on campus you do not need to get the meningitis vaccine.

Students can now see their health form and print it off by going to https://accessmu.maryville.edu/


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