Health Forms Checklist
This checklist is provided for your convenience to assist in completion of all required Health
Services forms included in this packet.
Before mailing your completed health forms to Health Services, please check to be sure all forms
are completed in English and you have included the following:
Health Assessment form, including your signature (or that of your parent/guardian
if you are less than 18 yrs of age) on the Release of Information section found on Page 3,
and a completed physical exam, signed by your Health Care Provider, on Page 4.
Immunization Record, signed by a Health Care Provider.
Meningococcal Meningitis Vaccination Response Form, including your signature
(or that of your parent/guardian if you are less than 18 yrs of age).
Tuberculosis Testing form, signed by a Health Care Provider.
Sports Physical Examination and History Form (lavender form), only if you plan to try
out for an athletic team. Please complete both sides, including appropriate signatures.
Notice of Privacy Practices. Please sign and date the form (again, if you are under
18 yrs of age, your parent/guardian must sign) and retain the yellow copy for your
A copy of both sides of your US–based health insurance card.
All forms are available on the Health Services web site www.skidmore.edu/administration/health