Physical Exam/Insurance Form                                                              [home]

Health and Insurance Requirements:

All students are required to have a completed health form on file at Shenandoah University's Wilkins Wellness Center prior to registration. (Forms may be downloaded by clicking student health form).

All students enrolled in Health Professions or School of Pharmacy must complete the Health Professions and Pharmacy form. 

Athletes: In addition to the University's Health and Insurance Requirement form all athletes must complete the athletic form and submit to the athletic department along with a copy of the physical examination page.  (Athletic forms may be downloaded by clicking athletic health form).

Students living on campus, participating in sports, and all health profession students are required to have a physical examination by their primary care provider.  Health Professions and Pharmacy students have additional immunization requirements that must be met prior to starting classes.

Commuter students, those not enrolled in a health program, or participating in a sport, are are not required to have a physical examination, however they must complete the remaining portions of the health form.

Insurance Information:

All students are required to provide proof of health insurance coverage (copy of current health insurance card) to the Wilkins Wellness Center, prior to registration. 

Health insurance may be purchased through www.studentresources.com.  Be sure to review the policy's exclusions and limitations prior to purchase.

Athletic Injury Information:  A COMPLETED CLAIM FORM MUST BE SUBMITTED WITHIN 90 DAYS FROM THE DATE OF INJURY.  You can visit the website at:  www.eiia.org/shenandoah

Every full-time student who participates in Intercollegiate athletics is automatically enrolled in the Athletic Accident Plan.  In the event of an accident, You must:
     1. Report the accident to your coach or athletic trainer immediately.
     2. File all charges with your primary insurance carrier first.  If you are insured by an
        HMO/PPO, you must obtain pre-authorization for all services rendered or benefits will be
        reduced by 50%.
     3. If the other insurance does not pay the entire bill, secure a claim form and instructions
        from the Athletic Department, fill in information completely, have the attending Physician
        and supervising coach complete their portion of the form, attach all itemized medical and
        hospital bills and mail them to the claims administrator. 

Injuries on Shenandoah University Property:

All injuries, other than athletic injuries, while on Shenandoah University property must be reported to the Wilkins Wellness Center within 24 hours of the accident/injury.

Wilkins Wellness Center:

General Information

Health Form/ Insurance Form
(Athletic form)

Counseling

Community Resources

Available Programs

Confidentiality