BSN Program - Indiana University South Bend 2026

1. Click ‘Get Form’ to open the BSN Program questionnaire in the editor.
2. Begin by answering the questions regarding your health history. For each question, select 'YES' or 'NO' based on your experience in the past year.
3. If you have had any illnesses or taken medications in the past year, specify them in the provided fields. Be thorough to ensure accurate health records.
4. Indicate the purpose of any medication you have taken in the designated area. This information is crucial for your health assessment.
5. Sign and date the form at the bottom to confirm that all information is accurate and complete.
6. Once completed, save your document and return it to the IUSB Office of Nursing Student Services, NS 416, as required.

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