Forms

Required Forms from Medical Packet

• Student Health Insurance Waiver Form
• Student Health Immunization Record
• Student Health Medical Questionnaire
• Vaccination Form for Meningitis & Hep B

Student Wellness Center Forms

• Release of Information from Another Facility to Student Wellness Center
• Release of Information from Student Wellness Center to Another Facility

Forms should be mailed to:
Student Wellness Center
400 East College Street
Georgetown, KY 40324

Documents about disabilities or special needs should be mailed to the Director of the Student Wellness Center at the same address.