Get Health Record Form - Radford University - Radford

Completing the Health Record Form for Radford University is an essential step in the enrollment process. This guide provides clear, step-by-step instructions to help you fill out the form accurately and efficiently, ensuring a smooth submission process.

Follow the steps to complete the Health Record Form online.

1. Press the ‘Get Form’ button to access the form and open it in your document editor.
2. Fill in your personal information, including your name, student ID number, date of birth, sex, and marital status. Ensure that your student ID number is accurate, as it is required for processing the form.
3. Provide your local address and telephone number. Also, include your permanent home address and contact details for your parent or guardian.
4. In case of an emergency, include the name and telephone number of someone who should be notified.
5. Specify your family physician's name and relationship to you, including their address.
6. Indicate your medical insurance information by listing the insurance company name and policy number.
7. Complete the medical history section, detailing any chronic illnesses, treatments, medications, and allergies.
8. If you are over 18, sign to give permission for the Student Health Center to treat you. If under 18, a parent or guardian must sign to authorize treatment.
9. Ensure the immunization section is filled out. Document all required immunizations and have a healthcare provider sign this section.
10. If applicable, complete the tuberculosis screening section with your healthcare provider, including any tests performed and results.
11. Review all information for accuracy before saving your changes. Afterward, download, print, or share the form as needed.

Complete your Health Record Form online today to ensure your enrollment at Radford University.