Welcome Letter from the Executive Director
Required Health Forms and Information for Incoming Undergraduate Students
(Adobe Acrobat Reader is required to view and print the following forms. If you do not have it you can download it from Adobe)
Section 1
Please print out the Physical Assessment and Immunization Record (links below) and have your health care provider complete and sign both forms. These forms must be mailed to:
Health Services
Attention Medical Records
12 Ballard Street
Durham, NH 03824DEADLINE TO SUBMIT THE PHYSCIAL ASSESSMENT AND IMMUNIZATION RECORD FORMS: July 1, 2012
- Physical Assessment (Required)
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First year students are required to have a physical exam upon entrance into the University. We understand that some students may have had a physical exam within the year and insurance companies will not pay for a second exam. If this is the case, please have your health care provider complete the Physical Assessment form with the date and information from your recent exam. If you do not have a current physical or physical appointment scheduled before the July 1st due date, late submissions will be accepted. Students intending to play a sport should contact their coach for specific physical date requirements.- Immunization Record (Required)
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Information on required and recommended immunizations…
Section 2
- Health History Form (Required) - This form will not be available until June 30, 2012. Please check back July 15, 2012 to complete this form.
COMPLETE ONLINE FORM ... NOTE: You will need you Blackboard username and password to login. This information was provided to you at June orientation. Incoming students are required to complete an online Health History Form. Students will need both the completed Physical Assessment and Immunization Record to assist them with completion of the Health History Form.Please read these important documents:
- Patients' Bill of Rights and Responsibilities
- Notice of Privacy Practices
UNH Health Services is committed to protecting the privacy of your health information. We provide you with a notice about our privacy practices to explain how, when, and why we use and disclose your health information.A health record is created when Health Services receives a student's Physical Assessment, Immunization Record and Health History Form, or upon his/her first visit to Health Services. For students who live with chronic illnesses, it may be helpful to submit additional health information to be made part of their medical record to assist with continuity of care.
Student Health Insurance
The University of New Hampshire requires all full-time degree students to have adequate health insurance as a condition of enrollment. Proof of insurance is required at the beginning of every academic year. Students have the option of waiving the requirement if proof of adequate insurance through another plan is provided; or alternatively they can acquire affordable health coverage under a plan sponsored by the University and administered by Health Plans, Inc., a subsidiary of Harvard Pilgrim Health Care.
As part of this requirement, all full-time degree students must take some action - by either enrolling in the UNH Student Health Benefits Plan (SHBP), or requesting a waiver. Students may learn more about the SHBP or fill out an online waiver by June 30, 2012 at www.unh.edu/shbp.
Note: Late payment penalties may be charged if plan is not waived and/or paid by tuition due deadline.
