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Health Forms

Student Health Form - The Student Health Form must be completed by all full-time first year and transfer students, no later than August 1st for entry in the Fall, or January 2nd for entry in the Spring. If you were previously a part-time student and are now taking 12 or more credits, you must complete a Student Health Form.

If you have received your Stevenson University issued Username and Password, you may use it to complete the form online. The Student Health Form is also presented in Adobe Portable Document format (PDF), which may be downloaded and printed. Forms will only be mailed upon request to the Wellness Center at 443-352-4200. Please submit your completed Student Health Form by mail or fax. Please keep a copy of all submissions for your records.

Consent to Release/Exchange Medical Information Form - Complete this consent form if you are trying to obtain or release your medical records to yourself or other parties. Please allow approximately 48 hours (two business days; excluding weekends and holidays) for records to be released. Every attempt will be made to process requests for medical records within 48 hours. Please fax, mail, or drop off your request to the Wellness Center.

Immunization Information for Students and their Medical Providers

Additional Health Record Submission Sheet - If you or your health care provider are submitting additional health records, please print, complete and attach this with any records.

Tuberculin Skin Test Assessment for a Positive TST - Students who had a normal chest x-ray are required to complete this form annually per their academic programming requirements. Refer to the department for specific guidelines.

Hepatitis B Declination Form - Student who are required to have the Hepatitis B immunization and titer (per their academic programming requirements) and are electing to decline revaccination of Hepatitis B should complete this form with the presence of a Wellness Center staff member.

 

Have a Question?

Contact the Wellness Center

Wellness Center
11001 Owings Mills Blvd.
Owings Mills, MD 21117
Phone: 443-352-4200
Fax: 443-352-4201

Emergency Contact
In case of life threatening emergency, dial 911.

Contact Campus Security
443-352-4500

 
 

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