Health Forms

Dear Lafayette College Students and Parents:

Lafayette College is committed to providing students with the best possible medical care. The Bailey Health Center at Lafayette College is staffed with physicians who are board certified in emergency medicine, internal medicine, psychiatry and family practice. Students are treated for acute medical problems and injuries. All physician services are provided at the Bailey Health Center free of charge. Please read the enclosed brochure for a more complete description of our hours, staff and services.

There are several health forms enclosed which must be completed and returned to the Bailey Health Center as soon as possible. All students are required to fill out the Lafayette student health forms. This includes a section on Medical History, which can be filled out by you, and a Physical Examination and an Immunization Record that must be completed by your physician.

Please plan to make an appointment with your physician early so that all forms can be returned in the enclosed envelope no later than July 15th.

Excessive alcohol use is a widespread problem in colleges and universities across the nation, and Lafayette College is expanding its efforts to educate students about this critical issue. High risk drinking affects the physical, academic and social well being of students. The college now mandates that first-year students take an on-line alcohol education program prior to fall orientation. My Student Body is an Internet alcohol education program that addresses many high profile issues associated with high risk college drinking. Students are required to take the course and pass a short quiz before the fall semester begins.

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Please read the following options carefully, and select the appropriate forms to download.

Adobe Acrobat Reader is required for viewing and printing the Lafayette College Application forms. If you do not have Acrobat Reader installed, please download Acrobat Reader from Adobe's web site.

Physical Examination

Medical History

Immunization Record

Emergency Notification and Medical Insurance Waiver Form
This form must be updated once a year by all students and their parent(s)/guardian(s).

Notice of Privacy Practice

To use the site and take the course, log onto www.mystudentbody.com and follow instructions. The school code is PARDS. You must pass the quiz to receive credit. Attached you will find complete instructions that will help you navigate through MyStudentBody.

We look forward to welcoming you to Lafayette College.

Respectfully,

Jeffrey E. Goldstein, M.D.
Director of Health Services
(610) 330-5001


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