Campus Clinic Health Forms

As of Friday, August 15th paperwork will NOT be accepted via fax, email or postal service.  If you have not submitted complete paperwork and complete immunization records prior to Friday, August 15 you will have a HOLD. Your paperwork must be turned in on Thursday, August 21st at Summer O.

Please complete the following:

Complete this Electronic Form

  1. Once it is filled out completely, save it to your computer witht he following file name:
    • Last Name, First Name, Student ID.doc (Example: Smith, Vivian 661217.doc)
  2. After you have save the document you can:
    • Print and mail to Student Health Center, Pyle Box 1231 (preferred method)
    • Email the form to
    • Fax it to Admissions at 937-382-8542

Required Immunizations

All forms should be mailed or faxed to:

Director of Health Services
1870 Quaker Way
Wilmington, OH 45177
fax: 937-383-8535

For questions, call:

Wilmington College main number: (937) 382-6661
Director of Health Services
Jill Young, ext. 217