D YOUVILLE COLLEGE STRONGLY RECOMMENDS ALL STUDENTS HAVE ... - dyc 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Date of Birth, Semester, Year of Entry, and Program in the designated fields. Ensure all information is accurate.
3. Fill out your complete permanent address, including Street, City, State/Province, Zip/Postal Code, and Telephone Number.
4. Provide your Country of Birth and Social Security Number (SS#/SIN) as required.
5. In the emergency contact section, list the Name and Relationship of a person to be notified in case of an emergency along with their telephone number.
6. Complete the Health Insurance Coverage section by entering the Company Name and Policy Number.
7. Sign the Authorization for Health Services section if you are over 18 years old; otherwise, have a parent or guardian sign.
8. Proceed to fill out the Report of Medical History and Physical Examination sections as instructed. Be thorough in providing health history details.

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