Get *** Do Not Send A Copy Of This Form To Your Campus Eap Office

This guide provides a detailed overview of how to accurately complete the *** DO NOT SEND A COPY OF THIS FORM TO YOUR CAMPUS EAP OFFICE. Following these steps will ensure that you meet the requirements for the UCEAP health clearance process, which is essential for your participation in the program.

Follow the steps to successfully complete your confidential health history form

1. Press the ‘Get Form’ button to access the document. This will open the form in your preferred online editor, allowing you to begin filling it out.
2. Carefully read the instructions provided on the form to understand the importance of accurate and complete information regarding your health history.
3. Fill in your personal details accurately, including your first name, last name, middle name, program or country of study, and student I.D.
4. Indicate the name and contact information of a person to notify in case of an emergency.
5. Provide information about your general health by listing any recent or ongoing health problems, including physical or learning disabilities.
6. If applicable, indicate whether you are currently under the care of a healthcare professional and provide their contact information.
7. Disclose any surgeries you have had, along with their types and years.
8. List any drug or food allergies you have and describe your reactions to them.
9. Complete the medical history section by checking the relevant boxes for chronic conditions and providing the corresponding dates where applicable.
10. Address your mental health history by checking yes or no for various conditions, and give explanations as necessary.
11. Indicate your immunization record by providing the dates of your immunizations.
12. List any medications you are currently taking, ensuring they are permissible abroad.
13. Describe any services you might need to support your education.
14. Review the form to ensure all information is complete and accurate before signing and dating it.
15. Save your completed document, and make sure to keep a copy with your passport for emergencies, as well as giving a copy to your healthcare provider.

Begin filling out your confidential health history form online today!