Lasell College Health Forms

All students please submit forms immediately. All forms are required.

The Health Center Staff welcomes you to the Lasell College. Below are Health Forms which need to be completed and returned to the Health Center office by August 1, 2013, for the Fall Semester and January 13, 2014, for the Spring Semester. In order to make your registration process go smoothly, please ensure you make an extra copy of the forms and bring them with you when arriving on campus. Please include a photocopy of the front and back of your insurance card and send along with the health form.

You should make an appointment with your health care provider as soon as possible in order to avoid delay of completing and forwarding your health forms.

The Health Form consists of five parts: 

Personal health history
This should be completed by you or with the help of a parent or guardian. It concerns basic information about your medical history.

Personal Health History

Physical exam, immunization, and tuberculosis questionnaire
These need be completed by a health care provider.

Physical Exam
Immunization Record
All of the vaccines listed on the Immunization form are required by law by the Commonwealth of Massachusetts.
Risk Questionnaire

Meningitis Waiver Form
This must be reviewed.  If you choose not to have the meningitis vaccine, the waiver form must be signed and returned.

Meningitis Waiver Form

Please note:
If you are considering a Study Abroad Program during your Lasell College career, please ask your health care provider to administer the Hepatitis A Vaccines. There may be other vaccines required for your particular travel, but are specific to geographic location.

It is important for you to know that each Health Form is held in confidence, and that no one has access to the health forms except Health Services personnel.  All visits to the Health Center (including treatments and discussions) are kept strictly confidential, except in the case of a medical emergency.

The Health Center is closed during the summer months. If you have any questions or concerns regarding these health forms, please contact the Office of Students Affairs at 617-243-2124 in June and July. The Health Center will reopen for administrative purposes only in August, and can be reached at 617-243-2451.

Please return your completed health forms in order to ensure delivery to the proper department. All Athletes’ health records will be shared with the Athletic Training staff.

For all Athletic Training students, please make an additional copy of all of your health records as you will need to present them to your advisor and your college internships.

Thank you,

The Health Services Staff at Lasell College

 






 

 

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