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Student Health Services - Philadelphia - Temple University 2026

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The document is a health form for students at various schools, including dental, medicine, pharmacy, physician assistant, podiatry, and public health. It requires healthcare providers to review the student's health data and complete the form to assist in providing necessary healthcare and accommodations for academic success. The form includes sections for general health assessment, vital signs, vision status, participation eligibility in activities, and a medical summary.

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Click ‘Get Form’ to open it in the editor.
Begin by selecting the appropriate school name from the options provided (Dental, Medicine, Pharmacy, Physician Assistant, Podiatry).
Fill in your personal details: enter your last name, first name, TU ID number, and date of birth in the designated fields.
Have your healthcare provider complete the examination section. They will need to review and document various health metrics such as blood pressure, pulse, height, and weight.
Indicate whether you can participate in all educational activities by checking 'Yes' or 'No'. If there are any restrictions or accommodations needed, please specify them in the provided space.
Finally, ensure that your healthcare provider fills out their information at the bottom of the form including their name, address, and signature along with the date.

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Versions	Form popularity	Fillable & printable
2024	4.4 Satisfied (38 Votes)
2023	4.6 Satisfied (20 Votes)
2014	4 Satisfied (33 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I email Temple Student Health Services?

We would like to hear from you. Please email comments or suggestions to StudentHealth@temple.edu.

Does Temple University offer health insurance for students?

Temple offers university-sponsored health insurance plans. Please visit Human Resources or call 215-926-2270 for more information. If you choose an HMO plan, you can still see Student Health Services for routine care. However, you will also need to choose a non-Student Health Services primary care provider ().

How much is health insurance for a student?

Students applying for their own health insurance plan can generally expect to pay a national average of $158 per month* for a short-term plan or $231 per month* for a major medical plan.

Is Temple Health part of Temple University?

Temple Health comprises the health, education and research activities carried out by the affiliates of Temple University Health System and the Lewis Katz School of Medicine at Temple University.

Is Temple student health services free?

Although seeing a provider is covered under a fee you pay in your tuition, some charges may be incurred during the visit including point of care testing, medication, immunizations and supplies.

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What is the Temple Promise program?

What is the Temple Promise? The Temple Promise is a new last-dollar financial aid grant program designed to make a world-class education at Temple University more accessible and affordable for the best and brightest students regardless of financial means.

Is Temple University Health System private or public?

Temple University Hospital Care system Private Funding Non-profit hospital Type Teaching Affiliated university Temple University School of Medicine18 more rows

Student Health Services - Philadelphia - Temple University 2026

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