Capital University

Student Health Forms

New Student Health Forms Packet
This document contains the following health forms: Student Health History, Meningococcal and Hepatitis B Vaccination Status Form and the Student Immunization Record. Students should download this packed only if all three forms are needed. Each form is available separately if only one is needed.

Health Information Release Request Form
Use this form to authorize Capital University's Kline Health Center to release your health history with the specified health care provider. This form is also available in the New Student Health Forms Packet. Do not, unnecessarily, complete two release reqeusts.

Immunization Record
New and transfer students need to complete this form to document your immunizations. This form must be completed before you begin registration for classes. This form is also available in the New Student Health Forms Packet. Do not, unnecessarily, complete two immunization records.

Health History Form (ONLY)
This document contains only the health history form. This form, and other health forms needed by new and transfer students, is available as a single document/packet titled the New Student Health Forms Packet. Do not, unnecessarily, complete two health history forms.

Capital University
1 College and Main, Columbus, OH 43209-2394
614-236-6011
Barbara Nash
Director
Capital University
Campus Health Center
1 College and Main
Columbus, OH
43209-2394
1-614-236-6114