EmailMeForm
Submit Health Records
Please complete this form to upload a copy of your Health Records.
Full Name:
*
Prefix
First
Last
Suffix
Student ID Number:
*
Phone:
*
###
-
###
-
####
Email
*
Residence Hall:
Please select
Dimple Newsome
Fleming Kee
TOSM
TOSW
Off-Campus
Off-Campus Address:
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Medical History Form:
*
Add File
Allowed file types include pdf, png, jpg, jpeg, and gif.
Download MEDICAL HISTORY FORM here.
Upload Immunization Records:
*
Add File
Allowed file types include pdf, png, jpg, jpeg, and gif.
Upload COVID-19 Proof of Vaccination:
*
Add File
Allowed file types include pdf, png, jpg, jpeg, and gif.
