Health Administrative Services- Medical Forms

You will receive an email with detailed instructions on how to submit your medical information in order to complete this university requirement. All full-time and part-time undergraduate students are required to complete the online Required Medical Forms. You will have access to the online forms after you receive the email.

• All students living on and off campus must complete the forms.
• You must complete the forms regardless of whether or not you plan to use healthcare services on campus.
• A physical is not required.

Students who will be living on campus must complete the online Options for Meningitis Compliance form prior to move-in day. This will require entering the date of the second meningitis ACWY vaccine dose or selecting the waiver option. See the online form for details.

NOTE: MINORS (students under 18 years old at the time the form is completed) who are not vaccinated for religious or other reasons must have a parent or guardian complete and submit the following form:

Meningitis Waiver for a Minor Form

INSURANCE INFORMATION (US citizens are not required to have medical insurance to attend KU)

If you are uninsured, the Affordable Care Act (ACA) provides many options for health insurance coverage. Visit Healthcare.gov  or call 1-800-318-2596 to see if you are eligible to enroll in a policy. Students may qualify for a subsidy to assist in payment of the premium. The window for enrollment is open in November, however, there are certain circumstances that permit enrollment anytime.

You will receive an email with detailed instructions on how to submit your medical information in order to complete this university requirement. The Health Insurance Requirement and TB Screening Questionnaire forms will be attached to the email. These forms and your immunization records are submitted via email. In addition, the Required Medical Forms must be completed online.

Once you receive the email, we recommend that you start working on these requirements as soon as  possible since you may need to visit your family doctor to complete the TB Screening and immunization requirements, and it may be helpful to have a family member assist you with purchasing health insurance.

REQUIRED VACCINES:

• Tdap in the last 10 years
• 2 - MMR vaccines
  1st dose - 12 months or older
  2nd dose - at least 28 days after the first dose
  Proof of immunity by blood test for measles, mumps and rubella is acceptable.
  NOTE: Students who are missing any of the required vaccines will have to obtain them at their own expense through Clinical Services on campus.

INSURANCE:

All international students are required to maintain health insurance while attending Kutztown University. Healthcare is complicated and expensive in the United States. International students are responsible for their medical expenses. Please note that most health insurance in the U.S. does not cover all medical expenses like prescriptions, dental and vision. You may visit the websites below for plan options or call to speak to a representative. Kutztown University does not endorse and is not affiliated with any of these insurance companies.

You will receive an email with detailed instructions on how to submit your medical information in order to complete this university requirement. The Health Insurance Requirement and TB Screening Questionnaire forms will be attached to the email. These forms are submitted via email.

Once you receive the email, we recommend that you start working on these requirements as soon as  possible since you may need to visit your family doctor to complete the TB Screening requirement, and it may be helpful to have a family member assist you with purchasing health insurance.

INSURANCE:

All international students are required to maintain health insurance while attending Kutztown University. Healthcare is complicated and expensive in the United States. International students are responsible for their medical expenses. Please note that most health insurance in the U.S. does not cover all medical expenses like prescriptions, dental and vision. You may visit the websites below for plan options or call to speak to a representative. Kutztown University does not endorse and is not affiliated with any of these insurance companies.

If you plan to live on campus or utilize the KU Health Center you must also complete the online Required Medical Forms and submit documentation for the required vaccines listed below.

REQUIRED VACCINES:

• Tdap Vaccine in the last 10 years
• 2 - MMR Vaccines
  1st dose - 12 months or older
  2nd dose - at least 28 days after 1st dose. Proof of immunity by blood test for measles, mumps and rubella is acceptable.

NOTE: Students who are missing any of the required vaccines will have to obtain them at their own expense through Clinical Services on campus.

If Clinical Services is utilized, you will be required to pay the per semester health center fee that will be placed on your KU account when you are seen for your first appointment.

IF YOU DO NOT PLAN TO UTILIZE THE KU HEALTH CENTER OR LIVE ON CAMPUS YOU ARE NOT REQUIRED TO COMPLETE ANY FORMS FOR THE HEALTH AND WELLNESS CENTER.

If you will be residing on campus, you must complete the Options for Meningitis Compliance Form online.

If Clinical Services is utilized, you will be required to do the following:

• Pay the per semester health center fee that will be placed on your KU account when you are seen for your first appointment.

• Complete all of the online Required Medical Forms.

• Click here to access Required Medical Forms