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Required Health Forms

Return all forms to:

Student Health Services
ATTN: Mary Mathiasen
Waldorf University
106 S. 6th St.
Forest City, Iowa 50436

For more information contact Mary Mathiasen at 641-585-8157.

All Freshmen and Transfer Students
(if an athlete, complete the additional forms in section below)

Meningococcal Document (Read Only) PDF Icon

Immunization Form PDF Icon

Medical History and Physical PDF Icon

Insurance Form PDF Icon

All Student-Athletes
(Student-Athletes must complete the following prior to participation in athletics)

Medical History and Physical PDF Icon

Insurance Form PDF Icon

Student-Athlete Waiver PDF Icon

Drug Testing Policy (Read Only) 

Drug Testing Authorization to Release Information PDF Icon

Drug Testing Consent PDF Icon

Drug Testing Receipt Acknowledgement PDF Icon

Authorization to Disclose Form

If you need to have your health care information disclosed to another party, please print and fill out the Authorization to Disclose Health Care Information Form below.

Authorization to Disclose Form PDF Icon

Immunization Waiver

If your medical records have been lost, destroyed, or are unobtainable OR you are exempt from immunization on medical or religious grounds, please print out and complete the Immunization Waiver below.

Immunization Waiver PDF Icon