STUDENT HEALTH FORM
This form is required for all Freshman, Transfer or Re-admitting students. Copy of current insurance card with subscribers date of birth.

Deadline:

• August 1st for first semester
• January 5th for Interim
• January 20th for second semester

This form must be received and immunization status approved by above deadlines. Failure to comply will result in disconnection of computer network access until both are received.

HEALTH INSURANCE WAIVER STATEMENT
This form is required by all students at Buena Vista University every year. This form states that you have your own health insurance and do not want to be automatically enrolled in the Student Health Insurance Plan offered by Buena Vista University.

Athletes Only:

PARENT/GUARDIAN/STUDENT INFORMATION FORM This form provides the Athletic department with primary insurance coverage information and MUST be filled out completely.

Note:  All athletes must have health forms completed by MD or DO or they won't be accepted.  Deadline for athletic forms are August 1st.

Note: If for any reason your insurance carrier changes or is discontinued, you must report this to Health Services within 10 working days.