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Connecticut university student health form 2025

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The University of Connecticut Student Health History Form for the 2019-2020 academic year requires students to submit their health history, including immunization records, tuberculosis risk assessment, and clearance for club sports. It outlines vaccination requirements for diseases such as MMR, varicella, and meningococcal, along with recommendations for additional vaccinations. The form also includes consent for treatment and insurance release information, emphasizing the importance of submitting completed forms by specified deadlines.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information, including your last name, first name, middle name, pronouns, sex assigned at birth, date of birth, gender identity, net ID, and preferred name. Ensure all fields are accurately filled out.
Proceed to the Immunization History section. For each vaccination required (MMR, Varicella, Meningococcal), select the appropriate option based on your vaccination history. If you have titer results instead of vaccinations, enter those details as well.
Complete the Tuberculosis Risk Questionnaire by answering all questions truthfully. If necessary, follow up with TB testing as indicated.
For NCAA student-athletes, ensure you provide Sickle Cell Trait Test results and attach any required lab reports.
Review the consent sections for treatment and insurance release. Sign and date where indicated to confirm your understanding and agreement.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (105 Votes)
2019	4.7 Satisfied (39 Votes)

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What is the student health and wellness fee at UConn?

2025-2026 Tuition Fees Academic Year 2025-2026CT ResidentNon-CT Resident Tuition $17010.00 $39678.00 General University Fee $132.00 $132.00 Infrastructure Maintenance Fee $688.00 $688.00 Student Health Wellness Fee $88.00 $88.005 more rows

What is a wellness fee?

Businesses with a certain number of employees are now required to offer some type of health benefits to staff. Their business model was not set up to account for this, so they use this fee to offset that cost. Its optional, and you can ask for it to be removed. Its becoming the standard in Los Angeles as well.

How to waive student health insurance UConn?

To decline/waive the insurance, you must use the Health Insurance Waiver in the PeopleSoft Financial system. Instructions on where to find and complete the waiver can be found at Waiving UConn Health Insurance - Student Academics and Services - UConn Knowledge Base.

What is the UConn student health and wellness fee?

2024-2025 Tuition Fees Academic Year 2024-2025CT ResidentNon-CT Resident Student Health Wellness Fee $80.00 $80.00 Transit Fee $54.00 $54.00 Technology Fee $184.00 $184.00 Activity Fee $80.00 $80.005 more rows

Is UConn Health a part of UConn?

UConn Health is a healthcare system and hospital, and branch of the University of Connecticut that oversees clinical care, advanced biomedical research, and academic education in medicine.