Medical History Form

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General Admission Packet Final.pdf

Welcome to the Ashland University Student Health Center

This packet contains necessary health record forms for full time undergraduate students enrolling at Ashland University. Please review and
complete each of the four sections and return them to:
Ashland University Student Health Center OR Fax to: 419-289-5209
401 College Avenue
Ashland, OH 44805
 

Part 1 of 4: Medical History Form

Please complete this health history form as completely as possible. This will allow us to provide the very best care for
you as a student at Ashland University. If you have a condition requiring continuing care (e.g., diabetes, hypertension,
emotional disorders, seizures, etc.) please have your health care provider send a letter with his/her suggestions for
necessary follow-up, medications, etc.