Downloadable Forms

All incoming students must complete the first page of this form, and take both pages to the physical examination appointment for review and completion by the healthcare provider. The form should be returned by July 31st to: Student Health Center, Washington and Lee University, 204 W. Washington Street, Lexington, VA 24450.

All incoming students must submit the Immunization Record, completed and signed by your healthcare provider. The form should be returned no later than July 31st, to: Student Health Center, Washington and Lee University, 204 W. Washington Street, Lexington, VA 24450.

All incoming students must complete the Tuberculosis Screening Questionnaire. If the answer to all of the screening questions in NO, then submit the form and no further action is required. If the answer to any of the screening questions is YES, then TB testing by a healthcare provider is required, with documentation submitted on the TB Clinical Assessment form. The form(s) should be returned by July 31st to: Student Health Center, Washington and Lee University, 204 W. Washington Street, Lexington, VA 24450-2116.

Students are required to provide evidence of adequate health and hospitalization insurance coverage to supplement the medical care provided by the University. The form must be returned no later than July 31st to Student Health Center, Washington and Lee University, 204 W. Washington Street, Lexington, VA 24450.

This is a supplemental medical history form for medical clearance for incoming Student-Athletes only. It must be completed/submitted prior to participation in NCAA athletics. This form is to be completed by the student, reviewed with the home healthcare provider at the time of visit for required physical examination and clearance for participation in NCAA athletics, and submitted by July 31st to: Student Health Center, Washington and Lee University, 204 W. Washington Street, Lexington, VA 24450.

Special housing is extremely limited. Only those students with the greatest medical need(s) will be recommended for special housing arrangements. In order to make this determination, it is important that the medical documentation supporting the request be complete. Please note that submitting this form does not constitute a request for disability accommodations.

This form is to be completed by the parent/guardian of incoming students who will be under age 18 at the time they first arrive on campus. The form should be returned no later than July 31st, to: Student Health Center, Washington and Lee University, 204 W. Washington Street, Lexington, VA 24450.

This form can be used to request that the Student Health Center share specific health information with another provider or another party (such as a dean or your parents), or to request that another provider share specific health information with the Student Health Center (such as immunization or treatment records). This is optional.