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Health, Wellness and Counseling Center Home
Health, Wellness and Counseling Center
Supporting Student Success

 

P.O. Box 730, Kutztown, PA 19530
Phone: (610) 683-4082
Administration Fax: (610) 683-4635
Clinical Services Fax:  (484) 646-4159
After-Hours Emergencies  (610) 683-4001
(Public Safety & Police Services)
Clinical Services

Dolores Hess, Director
William Lendzinski, Asst. Director
Health Administrative Services
Gail Hirsch, Medical Records Manager

   

   Kutztown University

              REQUIRED MEDICAL FORMS
WHO MUST COMPLETE THE REQUIREMENTS:
* ALL NEW UNDERGRADUATE STUDENTS
*
Students that plan to use Clinical Services and/or live on campus and/or enroll in the university health insurance plan.

COMPLETE THE FOLLOWING TWO-STEP PROCESS:

                               U.S. CITIZENS:
1. IMMUNIZATION REQUIREMENT FORM - This form cannot be completed electronically.  Print the form from the link or watch for a direct mailing with the information.
2. ON-LINE REQUIRED MEDICAL FORMS - Log onto MY HEALTH LINK to complete the forms

            INTERNATIONAL STUDENTS:
1. IMMUNIZATION & INSURANCE FORMS            
2. ON-LINE REQUIRED MEDICAL FORMS - Log onto MY HEALTH LINK to complete the forms.