Health Forms	Print

Listed below are the various important forms concerning Health Services at Messiah College. Located with each form is a description and details about how the form is to be completed. Please read each form carefully, as it is very important that the proper forms are completed and submitted prior to your arrival at Messiah College. Forms are due to Health Services on December 15, 2008 .

• Online Student Health History Form
  Submit your health history information ONLINE - access this form directly from the Health Services Channel! You may complete this form in one session, or save it and return at another time. You will also have the option of uploading scanned images of your medical insurance card, if desired. At the end, you will be asked to print your prefilled "Health Record and Examination" form to be filled out by your physician. When you've submitted your completed Online Student Health History form, it will be marked complete on the "Required Document Check List" channel on the Home tab.
• Health Record and Examination
  To be completed by your physician and returned to Health Services. Before you begin classes you must meet the immunization requirements. Failure to comply will result in registration delays. This form is available in two (2) formats. Please choose one:
  • Health Record and Examination (pdf)
  • Prefilled pdf form you can print after you submit your Online Student Health History (see above)
• Meningitis Vaccine
  In order to comply with Pennsylvania State legislation, Messiah must require that student present proof of meningococcal vaccination prior to being allowed to move into any campus housing. Please read all these forms and choose whichever form is appropriate for your situation:
  • Meningitis Statement (html)
  • Meningitis Vaccine Record (pdf)
  • Immunization Waiver (pdf)
• Hepatitis B Vaccine
  The American College Health Association, along with the Center for Disease Control (CDC) recommend the vaccine for all non-immunized college students. It consists of a series of three injections given over a period of six months. The Engle Center provides the vaccination at the lowest rate in town.
  • Hepatitis B Vaccine Information & Request (pdf)

Forms can be mailed to:

The Engle Center for Counseling and Health Services
Messiah College
Box 3028
One College Ave.
Grantham, PA 17027