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Health Forms

The Orientation website is updated frequently so please refresh your web browser each time you visit a page within the website to make sure you are getting the most up-to-date information.

Information as of May 19, 2017

Immunization Record Form

All new students are required to complete and submit the Immunization Record Form.

Medical History Form

All new students are required to complete and submit the Medical History Form.

Health Insurance Waiver

This form is required if you plan to not use the University's health insurance plan and instead use your own health insurance plan. Also, this form is required each year you have coverage under your own health insurance plan, not just at the start of your first year at Santa Clara.

If you have your own health insurance plan but fail to complete the Health Insurance Waiver by the deadline, you will be automatically enrolled in the University's health insurance plan and your student account will be charged for the annual policy.

Click here to learn more about the University's health insurance.

Click here for a PDF of health insurance information (including insurance waiver deadlines).

Deadlines

The respective deadlines for each form are:

  • Immunization Record Form: during your Orientation session
  • Medical History Form: during your Orientation session
  • Health Insurance Waiver: see above link for deadlines

Questions?

Contact: Cowell Center
408-554-4501