Kutztown University
  • About KU
  • Apply Today
  • Library
  • Request Info.
Kutztown Athletics

  • Health & Wellness Services
  • Clinical Services
  • Health Administrative Services
    • International Student Health Insurance
    • US Citizens Student Health Insurance
    • Record Requests and Confidentiality
    • Required Medical Forms
      • US Citizens
      • Graduate, Certification, Professional Credit, Lifelong Learning, and Online Program Students
      • International Students-Undergrad
      • International Students-Graduate
  • Health Promotion and Alcohol & Other Drug Services
  • Counseling & Psychological Services
  • Contact Health & Wellness Services
  • Academics
  • Admissions
  • Costs & Financial Aid
  • Life at KU
Contact Us
Health & Wellness Services
health@kutztown.edu
Beck Hall
Phone: 610-683-4082
Fax: 610-683-4635
Clinical Services Fax:
484-646-4159
After Hours Emergencies:
610-683-4001
Home > About KU > Administrative Offices > Health & Wellness Services > Health Administrative Services > Required Medical Forms
Bookmark and Share

Required Medical Forms

For optimal ease when you are completing the forms, we recommend using a desktop or laptop computer.

Please select the option that applies to you:

  • US Citizens -  Graduate, Certification, Professional Credit, Lifelong Learning and Online Program Students
  • US Citizens
  • International Students - Graduate
  • International Students - Undergrad

Kutztown University Kutztown University
of Pennsylvania
15200 Kutztown Road
Kutztown, PA 19530
610-683-4000
TDD 610-683-4499
A member of Pennsylvania's State System of Higher Education

  • Contact KU
  • Employment
  • KU en Español
  • Privacy Statement
  • News & Media
  • Right to Know
  • Safety & Emergency
  • Student Consumer Information
  • Fraud, Waste and Abuse Hotline
  • Events

Give to Kutztown University

Kutztown University Social Media

  • Facebook
  • YouTube
  • Twitter
  • LinkedIn
  • Instagram
More Social Media


Proud Member Pennsylvania's State System of Higher Education